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NPI 1104130970ActiveOrganization· Psychologist, Clinical· Fresno, CA

Psychologist, Clinical in Fresno, California, registered in NPPES in August 2010. The authorized official on file is Virginia Johnson, ED.D, Pyschologist.

Overview

NPI1104130970
StatusActive
Entity typeOrganization
NPI issuedAug 3, 2010
Last updated in NPPESDec 6, 2010

Specialties and licenses

TaxonomyCodeLicenseState
Psychologist, Clinical Primary103TC0700XPSY23518CA
Clinical Neuropsychologist103G00000XPSY23518CA
Behavior Analyst103K00000X1041645CA
Psychologist103T00000XPSY23518CA
Psychologist, Addiction (Substance Use Disorder)103TA0400XPSY23518CA
Psychologist, Adult Development & Aging103TA0700XPSY23518CA
Psychologist, Cognitive & Behavioral103TB0200XPSY23518CA
Psychologist, Counseling103TC1900XPSY23518CA
Psychologist, Clinical Child & Adolescent103TC2200XPSY23518CA
Psychologist, Family103TF0000XPSY23518CA
Psychologist, Intellectual & Developmental Disabilities103TM1800XPSY23518CA
Psychologist, Group Psychotherapy103TP2701XPSY23518CA
Psychologist, School103TS0200XPSY23518CA
Social Worker, School1041S0200X——
Psychiatry & Neurology, Psychiatry2084P0800XA76215CA

About license numbers in NPPES

Exclusion screening

ListResultDetails
HHS-OIG LEIE · Nov 10, 2026No matchChecked by NPI and by name + state
North Carolina Medicaid · Nov 11, 2026No match—
New York OMIG · Nov 11, 2026No match—
Ohio Medicaid · Nov 11, 2026No match—
Pennsylvania Medicheck · Nov 11, 2026No match—
Washington HCA · Nov 11, 2026No match—

Official OIG search · How matching works ·Bulk check a roster

Medicare

Enrollment (PECOS)Not in the public enrollment file of Oct 1, 2026

Medicare sources and data years

Other clinical psychologists in Fresno

All 170 clinical psychologists in Fresno · All clinical psychologists in California