Provider Demographics
NPI:1215162904
Name:LETT, JULLIETTE D
Entity type:Individual
Prefix:
First Name:JULLIETTE
Middle Name:D
Last Name:LETT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1005 S CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90021-2039
Mailing Address - Country:US
Mailing Address - Phone:213-482-6400
Mailing Address - Fax:213-482-6413
Practice Address - Street 1:1005 S CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90021-2039
Practice Address - Country:US
Practice Address - Phone:213-482-6400
Practice Address - Fax:213-482-6413
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-25
Last Update Date:2009-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No174400000XOther Service ProvidersSpecialist