Healthcare Provider Details

I. General information

NPI: 1982139663
Provider Name (Legal Business Name): INGRID JOHNSON REDDING LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: INGRID L JOHNSON

II. Dates (important events)

Enumeration Date: 05/01/2017
Last Update Date: 12/05/2025
Certification Date: 12/05/2025
Deactivation Date: 06/14/2019
Reactivation Date: 07/03/2019

III. Provider practice location address

9240 OLD REDWOOD HWY STE 246
WINDSOR CA
95492-9348
US

IV. Provider business mailing address

PO BOX 4124
NAPA CA
94558-0412
US

V. Phone/Fax

Practice location:
  • Phone: 707-278-8553
  • Fax:
Mailing address:
  • Phone: 707-477-1115
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberLMFT147734
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: