Provider Demographics
NPI:1841338654
Name:MCCORMICK, JULIA P (MFT)
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:P
Last Name:MCCORMICK
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 1:7797 HIGHWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:LA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:91941-6893
Mailing Address - Country:US
Mailing Address - Phone:619-335-3418
Mailing Address - Fax:
Practice Address - Street 1:7797 HIGHWOOD AVE
Practice Address - Street 2:
Practice Address - City:LA MESA
Practice Address - State:CA
Practice Address - Zip Code:91941-6893
Practice Address - Country:US
Practice Address - Phone:619-335-3418
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-02
Last Update Date:2022-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT36290106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist