Provider Demographics
NPI:1376168153
Name:ROSS, JULIE LYNN (LMFT)
Entity Type:Individual
Prefix:MS
First Name:JULIE
Middle Name:LYNN
Last Name:ROSS
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 1:930 QUARTERHORSE LN
Mailing Address - Street 2:
Mailing Address - City:OAK PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91377-3968
Mailing Address - Country:US
Mailing Address - Phone:818-961-6207
Mailing Address - Fax:
Practice Address - Street 1:660 HAMPSHIRE RD STE 100
Practice Address - Street 2:
Practice Address - City:WESTLAKE VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91361-2549
Practice Address - Country:US
Practice Address - Phone:805-497-0605
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-08
Last Update Date:2020-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT118583106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty