Provider Demographics
NPI:1336366681
Name:GALBREATH, JUANITA T (MFT)
Entity Type:Individual
Prefix:MS
First Name:JUANITA
Middle Name:T
Last Name:GALBREATH
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2251 E 21ST ST APT P
Mailing Address - Street 2:
Mailing Address - City:SIGNAL HILL
Mailing Address - State:CA
Mailing Address - Zip Code:90755-5984
Mailing Address - Country:US
Mailing Address - Phone:562-498-3551
Mailing Address - Fax:
Practice Address - Street 1:2251 E 21ST ST APT P
Practice Address - Street 2:
Practice Address - City:SIGNAL HILL
Practice Address - State:CA
Practice Address - Zip Code:90755-5984
Practice Address - Country:US
Practice Address - Phone:562-498-3551
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-19
Last Update Date:2011-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
CA65442101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health