Provider Demographics
NPI:1528134012
Name:SANDERS, JULIE ROBERTS (MA, MFT)
Entity type:Individual
Prefix:MS
First Name:JULIE
Middle Name:ROBERTS
Last Name:SANDERS
Suffix:
Gender:F
Credentials:MA, MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1605 HOPE ST
Mailing Address - Street 2:SUITE 305
Mailing Address - City:SOUTH PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91030-2628
Mailing Address - Country:US
Mailing Address - Phone:626-403-8076
Mailing Address - Fax:
Practice Address - Street 1:1605 HOPE ST
Practice Address - Street 2:SUITE 305
Practice Address - City:SOUTH PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91030-2628
Practice Address - Country:US
Practice Address - Phone:626-403-8076
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC35482106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist