Healthcare Provider Details

I. General information

NPI: 1699633297
Provider Name (Legal Business Name): VIVIAN D. BROWN JOHNSON M.A., LMFT# 151679
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: VIVIAN DELORES BROWN

II. Dates (important events)

Enumeration Date: 01/13/2026
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

950 S BASCOM AVE STE 1014
SAN JOSE CA
95128-3537
US

IV. Provider business mailing address

PO BOX 9065
VALLEJO CA
94591-9065
US

V. Phone/Fax

Practice location:
  • Phone: 408-758-0964
  • Fax:
Mailing address:
  • Phone: 510-501-0048
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number151679
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: