Provider Demographics
NPI:1588704324
Name:PORRES-FIERRO, JULIETA (LCSW)
Entity type:Individual
Prefix:MRS
First Name:JULIETA
Middle Name:
Last Name:PORRES-FIERRO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4415 MARYLAND AVE
Mailing Address - Street 2:
Mailing Address - City:LA CRESCENTA
Mailing Address - State:CA
Mailing Address - Zip Code:91214-2643
Mailing Address - Country:US
Mailing Address - Phone:818-326-5813
Mailing Address - Fax:818-781-5595
Practice Address - Street 1:13042 BURBANK BLVD
Practice Address - Street 2:
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91401-5409
Practice Address - Country:US
Practice Address - Phone:818-781-5511
Practice Address - Fax:818-781-5595
Is Sole Proprietor?:No
Enumeration Date:2007-02-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS 84301041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical