Provider Demographics
NPI:1427571504
Name:VARELA, JULIAN J (LMFT)
Entity Type:Individual
Prefix:
First Name:JULIAN
Middle Name:J
Last Name:VARELA
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:212 CARMEN LN
Mailing Address - Street 2:
Mailing Address - City:SANTA MARIA
Mailing Address - State:CA
Mailing Address - Zip Code:93458-7769
Mailing Address - Country:US
Mailing Address - Phone:805-212-7680
Mailing Address - Fax:
Practice Address - Street 1:6627 BAY LAUREL PL BLDG 5
Practice Address - Street 2:
Practice Address - City:AVILA BEACH
Practice Address - State:CA
Practice Address - Zip Code:93424-3504
Practice Address - Country:US
Practice Address - Phone:805-966-0303
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-20
Last Update Date:2020-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA116444106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA116444OtherLICENSED MARRIAGE & FAMILY THERAPIST
CA1245897354OtherMENTAL HEALTH