Provider Demographics
NPI:1215558168
Name:PETERSON, JULEE (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:JULEE
Middle Name:
Last Name:PETERSON
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 1:350 BACHMAN CT
Mailing Address - Street 2:
Mailing Address - City:LOS GATOS
Mailing Address - State:CA
Mailing Address - Zip Code:95030-5219
Mailing Address - Country:US
Mailing Address - Phone:818-209-0919
Mailing Address - Fax:
Practice Address - Street 1:330 N SANTA CRUZ AVE STE B
Practice Address - Street 2:
Practice Address - City:LOS GATOS
Practice Address - State:CA
Practice Address - Zip Code:95030-7277
Practice Address - Country:US
Practice Address - Phone:408-502-6476
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-01
Last Update Date:2020-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA117074101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health