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General NPI Number Information
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NPI Number | 1508063694
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Entity Type | Individual
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Provider Name | DAVID W JOHNSON MFC
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Gender | Male
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Dates
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Enumeration Date | 07/02/2007
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Last Update Date | 11/07/2022
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Provider Practice Location Address
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Address Line | 3097 WILLOW AVE STE 4
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City | CLOVIS
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State | CA
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Zip | 93612-4715
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Country | US
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Telephone | 559-707-9212
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Fax |
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Provider Business Mailing Address
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Address Line | 32197 MEADOW RIDGE RD
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City | COARSEGOLD
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State | CA
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Zip | 93614-9559
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Country | US
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Telephone | 559-642-2987
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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 | MFC35499
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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