Provider Demographics
NPI:1225153703
Name:PICADO, JULIA ANABEL (MFT)
Entity Type:Individual
Prefix:MS
First Name:JULIA
Middle Name:ANABEL
Last Name:PICADO
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14746 STANTON AVE
Mailing Address - Street 2:
Mailing Address - City:LA MIRADA
Mailing Address - State:CA
Mailing Address - Zip Code:90638-4940
Mailing Address - Country:US
Mailing Address - Phone:714-228-0177
Mailing Address - Fax:
Practice Address - Street 1:540 S EREMLAND DR
Practice Address - Street 2:
Practice Address - City:COVINA
Practice Address - State:CA
Practice Address - Zip Code:91723-3186
Practice Address - Country:US
Practice Address - Phone:626-966-1577
Practice Address - Fax:626-331-4529
Is Sole Proprietor?:No
Enumeration Date:2007-03-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 42161106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist