Provider Demographics
NPI:1285316000
Name:PICKETT, JOSHUA (LMFT)
Entity type:Individual
Prefix:
First Name:JOSHUA
Middle Name:
Last Name:PICKETT
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3701 LONG BEACH BLVD STE 330
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90807-3346
Mailing Address - Country:US
Mailing Address - Phone:657-200-1219
Mailing Address - Fax:
Practice Address - Street 1:3404 VIA LIDO # 200
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92663-3968
Practice Address - Country:US
Practice Address - Phone:949-541-8466
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-01
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA138155106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist