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General NPI Number Information
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NPI Number | 1386306116
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Entity Type | Organization
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Legal Business Name | JUNKO JOHNSON MARRIAGE & FAMILY THERAPY PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 10/08/2021
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Last Update Date | 10/08/2021
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Provider Practice Location Address
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Address Line | 25255 CABOT RD STE 228
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City | LAGUNA HILLS
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State | CA
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Zip | 92653-5529
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Country | US
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Telephone | 949-432-6693
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Fax | 949-298-3969
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Provider Business Mailing Address
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Address Line | 11 ARBORSIDE WAY
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City | MISSION VIEJO
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State | CA
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Zip | 92692-5950
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Country | US
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Telephone | 949-413-3350
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Fax | 949-298-3969
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Authorized Official
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Title or Position | PRESIDENT
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Name | JUNKO JOHNSON
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Credential | LMFT
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Telephone | 949-432-6693
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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