Provider Demographics
NPI:1447395546
Name:PIASCIK, JULIANNE
Entity Type:Individual
Prefix:
First Name:JULIANNE
Middle Name:
Last Name:PIASCIK
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 1:350 E 20TH ST # C
Mailing Address - Street 2:
Mailing Address - City:COSTA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:92627-2338
Mailing Address - Country:US
Mailing Address - Phone:949-515-2871
Mailing Address - Fax:
Practice Address - Street 1:2183 FAIRVIEW RD
Practice Address - Street 2:SUITE 100 & 211
Practice Address - City:COSTA MESA
Practice Address - State:CA
Practice Address - Zip Code:92627-5663
Practice Address - Country:US
Practice Address - Phone:949-515-2440
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA101YM0800XOtherUNLICENSED PROVIDERS OF M