Provider Demographics
NPI:1104788082
Name:PENROSE, JULIA K (AMFT)
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:K
Last Name:PENROSE
Suffix:
Gender:F
Credentials:AMFT
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:KILEY
Other - Last Name:PENROSE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:AMFT
Mailing Address - Street 1:PO BOX 70067
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:CA
Mailing Address - Zip Code:94807-0067
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 70067
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:CA
Practice Address - Zip Code:94807-0067
Practice Address - Country:US
Practice Address - Phone:415-260-3667
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-11-28
Last Update Date:2025-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAMFT159176101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty