Provider Demographics
NPI:1518505742
Name:DALE, JULIE A (LMFT)
Entity Type:Individual
Prefix:MS
First Name:JULIE
Middle Name:A
Last Name:DALE
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:PO BOX 196
Mailing Address - Street 2:
Mailing Address - City:MENIFEE
Mailing Address - State:CA
Mailing Address - Zip Code:92586-0196
Mailing Address - Country:US
Mailing Address - Phone:818-416-8075
Mailing Address - Fax:
Practice Address - Street 1:16861 PARTHENIA ST
Practice Address - Street 2:
Practice Address - City:NORTHRIDGE
Practice Address - State:CA
Practice Address - Zip Code:91343-4539
Practice Address - Country:US
Practice Address - Phone:818-988-4430
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-18
Last Update Date:2022-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA116857106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist