Provider Demographics
NPI:1619371101
Name:HOWARD, JULIE
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:HOWARD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24362 BERRENDO APT 6
Mailing Address - Street 2:
Mailing Address - City:LAGUNA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:92656-3167
Mailing Address - Country:US
Mailing Address - Phone:714-335-7213
Mailing Address - Fax:
Practice Address - Street 1:24362 BERRENDO
Practice Address - Street 2:APT 6
Practice Address - City:LAGUNA HILLS
Practice Address - State:CA
Practice Address - Zip Code:92656-3167
Practice Address - Country:US
Practice Address - Phone:714-335-7213
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-13
Last Update Date:2014-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA72582106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist