Most Relevant Information
Provider Data
| NPI Number: | 1003474859 |
| Provider Name: | VIVIAN JOHNSON LMFT |
| Entity Type: | Individual |
| Taxonomy Code: | 101YM0800X |
| Specialty: | Counselor |
| License Number: | 123948 |
Most Important Dates
| Enumeration Date: | 06/05/2019 |
| Last Updated: | 08/12/2021 |
Provider Practice Location
1654 AMBERWOOD DR APT E
SOUTH PASADENA
CA
910301929
Practice Location Phone/Fax
| Phone: | 3236832518 |
| Fax: |
Provider Mailing Location
1654 AMBERWOOD DR APT E
SOUTH PASADENA
CA
910301929
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |