Provider Demographics
NPI:1952669095
Name:JOHNSON, STEPHEN (PHD, BCBA)
Entity type:Individual
Prefix:
First Name:STEPHEN
Middle Name:
Last Name:JOHNSON
Suffix:
Gender:M
Credentials:PHD, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5110 HUCK FINN LN
Mailing Address - Street 2:
Mailing Address - City:CULVER CITY
Mailing Address - State:CA
Mailing Address - Zip Code:90230-4313
Mailing Address - Country:US
Mailing Address - Phone:310-488-7645
Mailing Address - Fax:
Practice Address - Street 1:2431 EADS ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90031-1018
Practice Address - Country:US
Practice Address - Phone:424-599-4947
Practice Address - Fax:424-550-1099
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-26
Last Update Date:2025-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1-07-3829103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1-07-3829OtherBCBA