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General NPI Number Information
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NPI Number | 1720204506
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Entity Type | Individual
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Provider Name | DAVID DEAN JOHNSON LPCC
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Gender | Male
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Dates
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Enumeration Date | 04/18/2007
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Last Update Date | 05/13/2021
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Provider Practice Location Address
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Address Line | 3 E 3RD AVE
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City | SAN MATEO
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State | CA
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Zip | 94401-4279
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Country | US
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Telephone | 650-275-2546
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Fax | 650-781-1801
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Provider Business Mailing Address
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Address Line | 1108 S EL CAMINO REAL
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City | SAN MATEO
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State | CA
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Zip | 94402-2804
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Country | US
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Telephone | 619-928-2267
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Fax | 650-458-0027
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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 | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 7541
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 7541
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | PCCI1792
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License Number State | CA
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