Provider Demographics
NPI:1790209906
Name:JULIE RAYHANABAD, PH.D., A PSYCHOLOGICAL CORPORATION
Entity Type:Organization
Organization Name:JULIE RAYHANABAD, PH.D., A PSYCHOLOGICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:
Authorized Official - Last Name:RAYHANABAD
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:909-258-4482
Mailing Address - Street 1:3851 KATELLA AVE STE 375
Mailing Address - Street 2:
Mailing Address - City:LOS ALAMITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90720-3377
Mailing Address - Country:US
Mailing Address - Phone:909-258-4482
Mailing Address - Fax:909-393-8566
Practice Address - Street 1:14708 PIPELINE AVE STE B
Practice Address - Street 2:
Practice Address - City:CHINO HILLS
Practice Address - State:CA
Practice Address - Zip Code:91709-1296
Practice Address - Country:US
Practice Address - Phone:909-393-8585
Practice Address - Fax:909-393-8566
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-29
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY29047103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty