Healthcare Provider Details

I. General information

NPI: 1689930851
Provider Name (Legal Business Name): ALISON LYNN JOHNSON LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/02/2012
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17111 BEACH BLVD STE 205
HUNTINGTON BEACH CA
92647-5947
US

IV. Provider business mailing address

17111 BEACH BLVD STE 205
HUNTINGTON BEACH CA
92647-5947
US

V. Phone/Fax

Practice location:
  • Phone: 714-654-1570
  • Fax:
Mailing address:
  • Phone: 714-654-1570
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMFC 49185
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: