Healthcare Provider Details

I. General information

NPI: 1164347449
Provider Name (Legal Business Name): BERNADETTE M JOHNSON NORTH COAST FAMILY COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/13/2026
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

508 H ST STE 9
CRESCENT CITY CA
95531-3723
US

IV. Provider business mailing address

500 TEDSEN LN
CRESCENT CITY CA
95531-7963
US

V. Phone/Fax

Practice location:
  • Phone: 707-460-0957
  • Fax:
Mailing address:
  • Phone: 707-460-0957
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: BERNADETTE MARIE JOHNSON
Title or Position: OWNER
Credential:
Phone: 707-460-0957