1063999175 NPI number — MR. CLAYTON JAMES JOHNSON M.A., LMFT, DIR

Table of content: MR. CLAYTON JAMES JOHNSON M.A., LMFT, DIR (NPI 1063999175)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1063999175 NPI number — MR. CLAYTON JAMES JOHNSON M.A., LMFT, DIR

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
JOHNSON
Provider First Name:
CLAYTON
Provider Middle Name:
JAMES
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
M.A., LMFT, DIR
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1063999175
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/01/2026
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2101 N GLENOAKS BLVD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BURBANK
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
91504-2828
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
818-848-8825
Provider Business Mailing Address Fax Number:
818-848-8815

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3524 COMMUNITY AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LA CRESCENTA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91214-2522
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
310-386-6670
Provider Business Practice Location Address Fax Number:
310-386-6670
Provider Enumeration Date:
07/21/2018

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 106H00000X , with the licence number:  107668 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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