Provider Demographics
NPI:1316348055
Name:RAYHANABAD, JULIE (PHD)
Entity type:Individual
Prefix:DR
First Name:JULIE
Middle Name:
Last Name:RAYHANABAD
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3851 KATELLA AVE STE 375
Mailing Address - Street 2:
Mailing Address - City:LOS ALAMITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90720-3377
Mailing Address - Country:US
Mailing Address - Phone:909-285-4482
Mailing Address - Fax:
Practice Address - Street 1:14708 PIPELINE AVE
Practice Address - Street 2:SUITE B
Practice Address - City:CHINO HILLS
Practice Address - State:CA
Practice Address - Zip Code:91709-1296
Practice Address - Country:US
Practice Address - Phone:909-393-8585
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-12
Last Update Date:2022-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY29047103TC0700X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical