Provider Demographics
NPI:1154516003
Name:JULIE A. WILNIER, PHD, CLINICAL PSYCHOLOGIST, INC.
Entity type:Organization
Organization Name:JULIE A. WILNIER, PHD, CLINICAL PSYCHOLOGIST, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:A
Authorized Official - Last Name:WILNIER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:949-293-5384
Mailing Address - Street 1:PO BOX 80166
Mailing Address - Street 2:
Mailing Address - City:RANCHO SANTA MARGARITA
Mailing Address - State:CA
Mailing Address - Zip Code:92688-0166
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:26391 CROWN VALLEY PKWY
Practice Address - Street 2:SUITE 110
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92691-7309
Practice Address - Country:US
Practice Address - Phone:949-600-9776
Practice Address - Fax:949-600-9776
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-12
Last Update Date:2007-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 20932103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty