Provider Demographics
NPI:1861151599
Name:JOHNSON-MAGAR, SHARON LYNNE (LMFT)
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:LYNNE
Last Name:JOHNSON-MAGAR
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13111 LAKE ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90066-2204
Mailing Address - Country:US
Mailing Address - Phone:707-280-3342
Mailing Address - Fax:
Practice Address - Street 1:4451 GLENCOE AVENUE
Practice Address - Street 2:SUITE 255
Practice Address - City:MARINA DEL REY
Practice Address - State:CA
Practice Address - Zip Code:90292
Practice Address - Country:US
Practice Address - Phone:310-572-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-09
Last Update Date:2021-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT32782101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health