Provider Demographics
NPI:1306038500
Name:CARLSON, JULIANNE CHRISTINSON (MFT)
Entity type:Individual
Prefix:MS
First Name:JULIANNE
Middle Name:CHRISTINSON
Last Name:CARLSON
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 1:25050 AVENUE KEARNY
Mailing Address - Street 2:SUITE #201
Mailing Address - City:SANTA CLARITA
Mailing Address - State:CA
Mailing Address - Zip Code:91355-1255
Mailing Address - Country:US
Mailing Address - Phone:818-970-5531
Mailing Address - Fax:
Practice Address - Street 1:25050 AVENUE KEARNY
Practice Address - Street 2:SUITE #201
Practice Address - City:SANTA CLARITA
Practice Address - State:CA
Practice Address - Zip Code:91355-1255
Practice Address - Country:US
Practice Address - Phone:818-970-5531
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-13
Last Update Date:2010-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA27088106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist