Healthcare Provider Details

I. General information

NPI: 1447103247
Provider Name (Legal Business Name): AMANDA JOHNSON AMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: AJ JOHNSON AMFT

II. Dates (important events)

Enumeration Date: 02/19/2026
Last Update Date: 02/19/2026
Certification Date: 02/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 MT DIABLO BLVD STE 203
WALNUT CREEK CA
94596-4800
US

IV. Provider business mailing address

1200 MT DIABLO BLVD STE 203
WALNUT CREEK CA
94596-4800
US

V. Phone/Fax

Practice location:
  • Phone: 925-257-0205
  • Fax:
Mailing address:
  • Phone: 925-257-0205
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number161165
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: