Healthcare Provider Details

I. General information

NPI: 1548775125
Provider Name (Legal Business Name): JAMES E JOHNSON LMFT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/05/2017
Last Update Date: 04/23/2025
Certification Date: 04/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9354 RICES TEXAS HILL RD.
OREGON HOUSE CA
95962-5768
US

IV. Provider business mailing address

PO BOX 212
OREGON HOUSE CA
95962-0212
US

V. Phone/Fax

Practice location:
  • Phone: 530-682-0339
  • Fax:
Mailing address:
  • Phone: 530-682-0339
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberLMFT153879
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: