Provider Demographics
NPI:1558015487
Name:CRIST, JULIE ANNE (LMFT)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:ANNE
Last Name:CRIST
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 1:3220 MEADOW CREEK LN
Mailing Address - Street 2:
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92027-6213
Mailing Address - Country:US
Mailing Address - Phone:760-271-9938
Mailing Address - Fax:
Practice Address - Street 1:3220 MEADOW CREEK LN
Practice Address - Street 2:
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92027-6213
Practice Address - Country:US
Practice Address - Phone:760-271-9938
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-09
Last Update Date:2022-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA130996103TP2701X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup Psychotherapy