Provider Demographics
NPI:1679819429
Name:JULIE GREINES, PSY.D., INC.
Entity Type:Organization
Organization Name:JULIE GREINES, PSY.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:GREINES
Authorized Official - Last Name:LAVINE
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:310-405-1792
Mailing Address - Street 1:10436 SANTA MONICA BLVD STE 3010
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90025-5079
Mailing Address - Country:US
Mailing Address - Phone:310-405-1792
Mailing Address - Fax:
Practice Address - Street 1:10436 SANTA MONICA BLVD STE 3010
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90025-5079
Practice Address - Country:US
Practice Address - Phone:310-405-1792
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-26
Last Update Date:2021-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty