Provider Demographics
NPI:1598736506
Name:AKIYAMA, JULIE S (PHD)
Entity Type:Individual
Prefix:DR
First Name:JULIE
Middle Name:S
Last Name:AKIYAMA
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1147 S WINDSOR BLVD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90019-3158
Mailing Address - Country:US
Mailing Address - Phone:330-307-5538
Mailing Address - Fax:
Practice Address - Street 1:9481 WILDERNESS RD
Practice Address - Street 2:CBHT-4 BLDG
Practice Address - City:FORT CARSON
Practice Address - State:CO
Practice Address - Zip Code:80913
Practice Address - Country:US
Practice Address - Phone:719-526-2542
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-28
Last Update Date:2014-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH6168103TC0700X
AZ1878103TC0700X
CAPSY12850103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical