Healthcare Provider Details

I. General information

NPI: 1295921906
Provider Name (Legal Business Name): BERNADETTE MARIE JOHNSON LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/18/2007
Last Update Date: 02/25/2026
Certification Date: 02/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

508 H ST
CRESCENT CITY CA
95531-3722
US

IV. Provider business mailing address

500 TEDSEN LN
CRESCENT CITY CA
95531-7963
US

V. Phone/Fax

Practice location:
  • Phone: 707-604-0957
  • Fax:
Mailing address:
  • Phone: 707-460-0957
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberLMFT98897
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: