Provider Demographics
NPI:1477343440
Name:KIRKPATRICK, JULIANNA CLAIRE
Entity type:Individual
Prefix:
First Name:JULIANNA
Middle Name:CLAIRE
Last Name:KIRKPATRICK
Suffix:
Gender:X
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1718 ELIZABETH ST
Mailing Address - Street 2:
Mailing Address - City:SAN CARLOS
Mailing Address - State:CA
Mailing Address - Zip Code:94070-2949
Mailing Address - Country:US
Mailing Address - Phone:650-450-7868
Mailing Address - Fax:
Practice Address - Street 1:4929 WILSHIRE BLVD STE 1000
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90010-3825
Practice Address - Country:US
Practice Address - Phone:323-743-1122
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-12
Last Update Date:2025-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAMFT143644106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist