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General NPI Number Information
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NPI Number | 1649317645
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Entity Type | Individual
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Provider Name | MELISSA ANN JOHNSON M.S.
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Gender | Female
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Dates
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Enumeration Date | 01/30/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 38970 BLACOW RD STE C
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City | FREMONT
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State | CA
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Zip | 94536-7380
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Country | US
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Telephone | 925-683-6664
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Fax | 510-794-8398
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Provider Business Mailing Address
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Address Line | PO BOX 2614
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City | LIVERMORE
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State | CA
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Zip | 94551-2614
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Country | US
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Telephone | 925-683-6664
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | IMF46116
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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 | IMF46116
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License Number State | CA
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