MEDICARE: ANJURE JOHNSON IMF

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	159503	CA

General Provider Information

NPI Number	:	1790920031
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANJURE JOHNSON IMF

Provider Business Mailing Address
First Line	:	940 AVENUE 64
Second Line	:
City	:	PASADENA
State	:	CA
Zip	:	91105
Country	:	US
Telephone Number	:	323-254-2274
Fax Number	:	323-254-9087

Provider Business Practice Location Address
First Line	:	940 AVENUE 64
Second Line	:
City	:	PASADENA
State	:	CA
Zip	:	91105
Country	:	US
Telephone Number	:	323-254-2274
Fax Number	:	323-254-9087

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

Provider Enumeration Date	:	12/15/2008
Last Update Date	:	01/13/2026

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