Provider Demographics
NPI:1750302899
Name:TIRPAK, JULIA MARIE (MFT)
Entity type:Individual
Prefix:MS
First Name:JULIA
Middle Name:MARIE
Last Name:TIRPAK
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:MS
Other - First Name:JULIE
Other - Middle Name:MARIE
Other - Last Name:TIRPAK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MFT
Mailing Address - Street 1:8318 UNIVERSITY AVE
Mailing Address - Street 2:SUITE A- 5
Mailing Address - City:LA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:91941-3865
Mailing Address - Country:US
Mailing Address - Phone:619-507-5590
Mailing Address - Fax:
Practice Address - Street 1:8318 UNIVERSITY AVE
Practice Address - Street 2:SUITE A- 5
Practice Address - City:LA MESA
Practice Address - State:CA
Practice Address - Zip Code:91941-3865
Practice Address - Country:US
Practice Address - Phone:619-507-5590
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 33562106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist