Provider Demographics
NPI:1154496115
Name:BARAK, JULIANNE (MA)
Entity Type:Individual
Prefix:MRS
First Name:JULIANNE
Middle Name:
Last Name:BARAK
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31573 RANCHO PUEBLO RD STE 200
Mailing Address - Street 2:
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92592-4854
Mailing Address - Country:US
Mailing Address - Phone:858-279-1223
Mailing Address - Fax:951-225-6160
Practice Address - Street 1:31573 RANCHO PUEBLO RD STE 200
Practice Address - Street 2:
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92592-4854
Practice Address - Country:US
Practice Address - Phone:858-279-1223
Practice Address - Fax:951-255-6160
Is Sole Proprietor?:No
Enumeration Date:2006-11-22
Last Update Date:2022-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
CAMFC48150106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health