MEDICARE: BRYCE ANTHONY JOHNSON AMFT

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
2	106H00000X	Marriage & Family Therapist	AMFT127365	CA

General Provider Information

NPI Number	:	1326668518
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRYCE ANTHONY JOHNSON AMFT

Provider Business Mailing Address
First Line	:	1666 RAMONA AVE
Second Line	:
City	:	GROVER BEACH
State	:	CA
Zip	:	93433-2203
Country	:	US
Telephone Number	:	805-474-7060
Fax Number	:

Provider Business Practice Location Address
First Line	:	1666 RAMONA AVE
Second Line	:
City	:	GROVER BEACH
State	:	CA
Zip	:	93433-2203
Country	:	US
Telephone Number	:	805-473-7060
Fax Number	:

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

Provider Enumeration Date	:	04/17/2020
Last Update Date	:	08/26/2025

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