Provider Demographics
NPI:1023310109
Name:RODRIGUEZ, JULIE (LMFT)
Entity type:Individual
Prefix:MS
First Name:JULIE
Middle Name:
Last Name:RODRIGUEZ
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 1:4645 E ANAHEIM ST
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90804-3122
Mailing Address - Country:US
Mailing Address - Phone:562-682-5556
Mailing Address - Fax:877-581-6430
Practice Address - Street 1:4645 E ANAHEIM ST
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90804-3122
Practice Address - Country:US
Practice Address - Phone:562-682-5556
Practice Address - Fax:877-581-6430
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-23
Last Update Date:2014-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC32644106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist