Provider Demographics
NPI:1316168511
Name:DUNNIGAN, JULIE MARIE (MFT)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:MARIE
Last Name:DUNNIGAN
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 1:107 PEPPER LN
Mailing Address - Street 2:
Mailing Address - City:PETALUMA
Mailing Address - State:CA
Mailing Address - Zip Code:94952-9694
Mailing Address - Country:US
Mailing Address - Phone:707-290-4225
Mailing Address - Fax:
Practice Address - Street 1:7 4TH ST STE 31
Practice Address - Street 2:
Practice Address - City:PETALUMA
Practice Address - State:CA
Practice Address - Zip Code:94952-3094
Practice Address - Country:US
Practice Address - Phone:707-290-4225
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2022-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA38362106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA38362OtherMFC LICENSE