Provider Demographics
NPI:1952138901
Name:HOWARD, JOHN WALTER (LMFT)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:WALTER
Last Name:HOWARD
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2001 RANGE AVE APT 40
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95401-7007
Mailing Address - Country:US
Mailing Address - Phone:707-583-3416
Mailing Address - Fax:
Practice Address - Street 1:2001 RANGE AVE APT 40
Practice Address - Street 2:
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95401-7007
Practice Address - Country:US
Practice Address - Phone:707-583-3416
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-16
Last Update Date:2024-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA147800106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist