Provider Demographics
NPI:1770195091
Name:ROCCANOVA, JULIA ROSE (LMFT)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:ROSE
Last Name:ROCCANOVA
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 1:6386 ALVARADO CT STE 310
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92120-4908
Mailing Address - Country:US
Mailing Address - Phone:619-668-6200
Mailing Address - Fax:
Practice Address - Street 1:6386 ALVARADO CT STE 310
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92120-4908
Practice Address - Country:US
Practice Address - Phone:196-668-6200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-18
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA144659106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist