MEDICARE: MELISSA ANN JOHNSON M.S.

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	101YM0800X	Mental Health Counselor	IMF46116	CA
2	106H00000X	Marriage & Family Therapist	IMF46116	CA

General Provider Information

NPI Number	:	1649317645
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELISSA ANN JOHNSON M.S.

Provider Business Mailing Address
First Line	:	PO BOX 2614
Second Line	:
City	:	LIVERMORE
State	:	CA
Zip	:	94551-2614
Country	:	US
Telephone Number	:	925-683-6664
Fax Number	:

Provider Business Practice Location Address
First Line	:	38970 BLACOW RD STE C
Second Line	:
City	:	FREMONT
State	:	CA
Zip	:	94536-7380
Country	:	US
Telephone Number	:	925-683-6664
Fax Number	:	510-794-8398

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

Provider Enumeration Date	:	01/30/2007
Last Update Date	:	09/11/2025

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Directions to “ MELISSA ANN JOHNSON M.S.” Practice Location

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