Provider Demographics
NPI:1477601920
Name:CHOUTEAU, JULIE BAKER (LMFT)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:BAKER
Last Name:CHOUTEAU
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:H
Other - Last Name:BAKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:711 D ST STE 208
Mailing Address - Street 2:
Mailing Address - City:SAN RAFAEL
Mailing Address - State:CA
Mailing Address - Zip Code:94901-3704
Mailing Address - Country:US
Mailing Address - Phone:415-816-9514
Mailing Address - Fax:
Practice Address - Street 1:711 D ST STE 208
Practice Address - Street 2:
Practice Address - City:SAN RAFAEL
Practice Address - State:CA
Practice Address - Zip Code:94901
Practice Address - Country:US
Practice Address - Phone:415-816-9514
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2018-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 49973106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist