Provider Demographics
NPI:1447598461
Name:HA, JULIE (MA)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:HA
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8892 BLACKHEATH CIR
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CA
Mailing Address - Zip Code:92683-6823
Mailing Address - Country:US
Mailing Address - Phone:949-533-1176
Mailing Address - Fax:
Practice Address - Street 1:8892 BLACKHEATH CIR
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CA
Practice Address - Zip Code:92683-6823
Practice Address - Country:US
Practice Address - Phone:949-533-1176
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-25
Last Update Date:2013-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA52500106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist