Provider Demographics
NPI:1427450253
Name:MAY, JULIA MARIE (LMFT131138)
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:MARIE
Last Name:MAY
Suffix:
Gender:F
Credentials:LMFT131138
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:553 N PCH HWY STE B520
Mailing Address - Street 2:
Mailing Address - City:REDONDO BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90277-2163
Mailing Address - Country:US
Mailing Address - Phone:424-212-0770
Mailing Address - Fax:
Practice Address - Street 1:700 N PACIFIC COAST HWY
Practice Address - Street 2:
Practice Address - City:REDONDO BEACH
Practice Address - State:CA
Practice Address - Zip Code:90277-2167
Practice Address - Country:US
Practice Address - Phone:424-212-0770
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-24
Last Update Date:2023-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA131138106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CALMFT131138OtherBBS LICENSE