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NPI Code Detail

MEDICARE: MRS. AMY JESSICA FLORES-JOHNSON MFTI

MEDICARE: MRS. AMY JESSICA FLORES-JOHNSON MFTI
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
1101Y00000XCounselor
2101YM0800XMental Health Counselor
3106H00000XMarriage & Family Therapist92129CA

General Provider Information

NPI Number : 1528191038
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. AMY JESSICA FLORES-JOHNSON MFTI
Provider Business Mailing Address
First Line : 1624 SANTA CLARA DR STE 145
Second Line :
City : ROSEVILLE
State : CA
Zip : 95661-3500
Country : US
Telephone Number : 916-764-7045
Fax Number :
Provider Business Practice Location Address
First Line : 1624 SANTA CLARA DR STE 145
Second Line :
City : ROSEVILLE
State : CA
Zip : 95661-3500
Country : US
Telephone Number : 916-779-2455
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/13/2007
Last Update Date : 04/03/2023

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