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General NPI Number Information
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NPI Number | 1295330710
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Entity Type | Individual
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Provider Name | TARYN C JOHNSON MFT
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Gender | Female
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Dates
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Enumeration Date | 12/02/2020
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Last Update Date | 12/02/2020
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Provider Practice Location Address
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Address Line | 400 CAPITOL MALL FL 8
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City | SACRAMENTO
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State | CA
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Zip | 95814-4430
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Country | US
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Telephone | 916-852-5662
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Fax |
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Provider Business Mailing Address
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Address Line | 13374 ARMITSTEAD CIR
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City | SONORA
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State | CA
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Zip | 95370-8704
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Country | US
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Telephone | 209-483-3922
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 98107
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License Number State | CA
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