Provider Demographics
NPI:1336334770
Name:JOHNSON, TURA ULYNN (MA, LMFT)
Entity type:Individual
Prefix:
First Name:TURA
Middle Name:ULYNN
Last Name:JOHNSON
Suffix:
Gender:
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:533 AIRPORT BLVD STE 400
Mailing Address - Street 2:
Mailing Address - City:BURLINGAME
Mailing Address - State:CA
Mailing Address - Zip Code:94010-2013
Mailing Address - Country:US
Mailing Address - Phone:650-297-7216
Mailing Address - Fax:
Practice Address - Street 1:533 AIRPORT BLVD STE 400
Practice Address - Street 2:
Practice Address - City:BURLINGAME
Practice Address - State:CA
Practice Address - Zip Code:94010-2013
Practice Address - Country:US
Practice Address - Phone:650-297-7216
Practice Address - Fax:650-658-8597
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-10
Last Update Date:2025-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA105623106H00000X
101YM0800X
CAIMF 75175106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health