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General NPI Number Information
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NPI Number | 1528629623
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Entity Type | Individual
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Provider Name | SHANEKKA NICOLE BROWN-JOHNSON LMFT
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Gender | Female
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Dates
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Enumeration Date | 06/28/2019
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Last Update Date | 01/21/2026
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Provider Practice Location Address
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Address Line | 5588 N PALM AVE
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City | FRESNO
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State | CA
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Zip | 93704-1913
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Country | US
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Telephone | 860-469-5439
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Fax |
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Provider Business Mailing Address
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Address Line | 1985 DEL AMO BLVD # P1431
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City | TORRANCE
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State | CA
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Zip | 90501-1304
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Country | US
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Telephone | 860-469-5439
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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 | AMFT110512
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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 | LMFT145841
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 5162-R
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License Number State | NV
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Taxonomy #4
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Taxonomy Code | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number | AMFT110512
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License Number State | CA
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Taxonomy #5
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 238586
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License Number State | AK
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