Healthcare Provider Details

I. General information

NPI: 1669311973
Provider Name (Legal Business Name): GIANNA LILLIAN JOHNSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2026
Last Update Date: 09/08/2026
Certification Date: 03/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2635 ZANKER RD
SAN JOSE CA
95134-2107
US

IV. Provider business mailing address

459 AVENUE DEL ORA
REDWOOD CITY CA
94062-2201
US

V. Phone/Fax

Practice location:
  • Phone: 408-292-9353
  • Fax:
Mailing address:
  • Phone: 650-556-4898
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number165002
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: