Provider Demographics
NPI:1245426352
Name:MCHUGH, JULIA MARISA (PSYD)
Entity Type:Individual
Prefix:DR
First Name:JULIA
Middle Name:MARISA
Last Name:MCHUGH
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:634 W SIERRA MADRE BLVD
Mailing Address - Street 2:APT K
Mailing Address - City:SIERRA MADRE
Mailing Address - State:CA
Mailing Address - Zip Code:91024-2277
Mailing Address - Country:US
Mailing Address - Phone:909-855-7755
Mailing Address - Fax:
Practice Address - Street 1:634 W SIERRA MADRE BLVD
Practice Address - Street 2:APT K
Practice Address - City:SIERRA MADRE
Practice Address - State:CA
Practice Address - Zip Code:91024-2277
Practice Address - Country:US
Practice Address - Phone:909-855-7755
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-21
Last Update Date:2016-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY25973103T00000X, 103TC0700X
101Y00000X
CA# RPS2011071225400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No101Y00000XBehavioral Health & Social Service ProvidersCounselor