Healthcare Provider Details

I. General information

NPI: 1477740363
Provider Name (Legal Business Name): DIANNA MARIE JOHNSON SBHS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DIANNA MARIE JOHNSON LMFT

II. Dates (important events)

Enumeration Date: 09/25/2007
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

45926 OASIS ST
INDIO CA
92201-4559
US

IV. Provider business mailing address

7885 ANNANDALE AVE
DESERT HOT SPRINGS CA
92240-1419
US

V. Phone/Fax

Practice location:
  • Phone: 760-342-1233
  • Fax: 760-342-5344
Mailing address:
  • Phone: 760-329-2924
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number123779
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberAPCC5303
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number6623
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberAMFT107693
License Number StateCA
# 5
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMFT.0002758
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: