Provider Demographics
NPI:1912764333
Name:RABBANI, JULIE ROSE (MFT)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:ROSE
Last Name:RABBANI
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 1:26895 ALISO CREEK RD STE B
Mailing Address - Street 2:
Mailing Address - City:ALISO VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92656-5302
Mailing Address - Country:US
Mailing Address - Phone:310-467-0972
Mailing Address - Fax:
Practice Address - Street 1:2547 W SHAW AVE STE 117
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93711-3321
Practice Address - Country:US
Practice Address - Phone:559-412-7799
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-01
Last Update Date:2024-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAMFT145356101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health