Provider Demographics
NPI:1245415181
Name:LORENZ-JUSTUS, JULIE ANN
Entity Type:Individual
Prefix:MS
First Name:JULIE
Middle Name:ANN
Last Name:LORENZ-JUSTUS
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 1:650 HOWE AVE STE 200
Mailing Address - Street 2:200
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95825-4732
Mailing Address - Country:US
Mailing Address - Phone:916-993-4193
Mailing Address - Fax:916-993-4886
Practice Address - Street 1:650 HOWE AVE STE 200
Practice Address - Street 2:200
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95825-4732
Practice Address - Country:US
Practice Address - Phone:916-993-4193
Practice Address - Fax:916-993-4886
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-09
Last Update Date:2011-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA94-2777955101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health