Dr. Jacqueline Marie Johnson
Counselor, Mental Health in San Diego, CA. Individual provider (NPI-1).
NPI number1295513638
StatusActive
Last updated in NPPESSep 18, 2023
Details
- NPI
- 1295513638
- Entity type
- Individual (NPI-1)
- Name
- Dr. Jacqueline Marie Johnson
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Sep 18, 2023
- Certification date
- Sep 18, 2023
- Last updated
- Sep 18, 2023
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YM0800X | Counselor, Mental Health | AMFT139657 | CA | Yes |
Practice location
1925 Euclid Ave Ste 108San Diego, CA 92105-5362
Phone 619-648-1158
Mailing address
517 21st StSan Diego, CA 92102-2814
Phone 858-245-3045
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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