Provider Demographics
NPI:1194829085
Name:WRIGHT, JULIE A
Entity Type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:A
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 72
Mailing Address - Street 2:
Mailing Address - City:NEWBURY PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91319-0072
Mailing Address - Country:US
Mailing Address - Phone:805-435-9001
Mailing Address - Fax:805-499-8666
Practice Address - Street 1:501 MARIN ST
Practice Address - Street 2:SUITE 108
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91360-4260
Practice Address - Country:US
Practice Address - Phone:805-435-9001
Practice Address - Fax:805-499-8666
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC31489106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist