Provider Demographics
NPI:1497887616
Name:LARAWAY, JULIE (LMFT)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:LARAWAY
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23560 LYONS AVE
Mailing Address - Street 2:NEWHALL
Mailing Address - City:NEWHALL
Mailing Address - State:CA
Mailing Address - Zip Code:91321-2521
Mailing Address - Country:US
Mailing Address - Phone:661-236-8925
Mailing Address - Fax:661-799-9906
Practice Address - Street 1:23560 LYONS AVE
Practice Address - Street 2:NEWHALL
Practice Address - City:NEWHALL
Practice Address - State:CA
Practice Address - Zip Code:91321-2521
Practice Address - Country:US
Practice Address - Phone:661-236-8925
Practice Address - Fax:661-799-9906
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC41695106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist