Provider Demographics
NPI:1336773902
Name:SMART, JULIA AFABLE (MS, LMFT)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:AFABLE
Last Name:SMART
Suffix:
Gender:F
Credentials:MS, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1437 BAYPOINTE DR
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-8517
Mailing Address - Country:US
Mailing Address - Phone:949-933-0070
Mailing Address - Fax:
Practice Address - Street 1:18700 MAIN ST STE 202
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92648-1714
Practice Address - Country:US
Practice Address - Phone:949-933-0070
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-23
Last Update Date:2020-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA107201106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist