Provider Demographics
NPI:1174704480
Name:DENNIS-JOHNSON, BELINDA MARIE (MA, MFT)
Entity type:Individual
Prefix:MS
First Name:BELINDA
Middle Name:MARIE
Last Name:DENNIS-JOHNSON
Suffix:
Gender:F
Credentials:MA, MFT
Other - Prefix:MS
Other - First Name:BELINDA
Other - Middle Name:MARIE
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMFT
Mailing Address - Street 1:21561 FLAMENCO
Mailing Address - Street 2:
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92692-1014
Mailing Address - Country:US
Mailing Address - Phone:949-633-5056
Mailing Address - Fax:949-951-5056
Practice Address - Street 1:23120 ALICIA PKWY STE 200
Practice Address - Street 2:
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92692-1212
Practice Address - Country:US
Practice Address - Phone:949-633-5056
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-15
Last Update Date:2024-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA36068106H00000X
CAMFT 36068106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA37-1494632OtherPRIVATE PRACTICE