Provider Demographics
NPI:1124113568
Name:JOHNSON, MARGARET ANN (MFT)
Entity type:Individual
Prefix:
First Name:MARGARET
Middle Name:ANN
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4419 VAN NUYS BLVD
Mailing Address - Street 2:SUITE 406
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91403-2910
Mailing Address - Country:US
Mailing Address - Phone:818-386-0558
Mailing Address - Fax:818-386-0816
Practice Address - Street 1:4419 VAN NUYS BLVD
Practice Address - Street 2:SUITE 300
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91403
Practice Address - Country:US
Practice Address - Phone:818-386-0558
Practice Address - Fax:818-782-2243
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2012-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC23982106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist