MEDICARE: MR. JOHN J GARRISON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist

General Provider Information

NPI Number	:	1134966518
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JOHN J GARRISON

Provider Business Mailing Address
First Line	:	4739 WILLIS AVE APT 301
Second Line	:
City	:	SHERMAN OAKS
State	:	CA
Zip	:	91403-6000
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5550 TOPANGA CANYON BLVD
Second Line	:
City	:	WOODLAND HILLS
State	:	CA
Zip	:	91367-6478
Country	:	US
Telephone Number	:	818-912-6001
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/11/2024
Last Update Date	:	07/11/2024

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Directions to “ MR. JOHN J GARRISON ” Practice Location

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