Healthcare Provider Details

I. General information

NPI: 1780591495
Provider Name (Legal Business Name): MELANIE JOHNSTON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/26/2026
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20969 VENTURA BLVD STE 216C
WOODLAND HILLS CA
91364-6690
US

IV. Provider business mailing address

6221 VAN NUYS BLVD UNIT 539
VAN NUYS CA
91401-2710
US

V. Phone/Fax

Practice location:
  • Phone: 818-572-2873
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number133336
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: