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General NPI Number Information
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NPI Number | 1861966087
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Entity Type | Individual
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Provider Name | KIMSON F JOHNSTON MA, LMFT
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Gender | Female
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Dates
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Enumeration Date | 01/22/2019
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Last Update Date | 01/06/2020
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Provider Practice Location Address
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Address Line | 1370 BREA BLVD SUITE 210
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City | FULLERTON
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State | CA
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Zip | 92835
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Country | US
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Telephone | 714-253-7675
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Fax | 657-286-5272
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Provider Business Mailing Address
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Address Line | PO BOX 93
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City | PLACENTIA
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State | CA
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Zip | 92871
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Country | US
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Telephone | 714-253-7675
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Fax | 657-286-5272
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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 | 45925
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License Number State | CA
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