Provider Demographics
NPI:1437210135
Name:ROUNDY, JULIA V (MFT)
Entity Type:Individual
Prefix:MS
First Name:JULIA
Middle Name:V
Last Name:ROUNDY
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:JULIA
Other - Middle Name:ROUNDY
Other - Last Name:BOMBEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MFT
Mailing Address - Street 1:226 SANTA BARBARA WAY
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:94533-2236
Mailing Address - Country:US
Mailing Address - Phone:707-425-1402
Mailing Address - Fax:
Practice Address - Street 1:2101 COURAGE DR
Practice Address - Street 2:CRISISCENTER
Practice Address - City:FAIRFIELD
Practice Address - State:CA
Practice Address - Zip Code:94533-6717
Practice Address - Country:US
Practice Address - Phone:707-784-2140
Practice Address - Fax:707-784-2164
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA35629106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist