Healthcare Provider Details

I. General information

NPI: 1427119148
Provider Name (Legal Business Name): TARSILA E JOHNSON LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: GENIE JOHNSON LMFT

II. Dates (important events)

Enumeration Date: 12/13/2006
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

375 HARBOUR COVE DR APT 427
SPARKS NV
89434-7808
US

IV. Provider business mailing address

375 HARBOUR COVE DR APT 427
SPARKS NV
89434-7808
US

V. Phone/Fax

Practice location:
  • Phone: 520-488-8161
  • Fax:
Mailing address:
  • Phone: 520-488-8161
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number5356-R
License Number StateNV
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMFT47726
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: