Provider Demographics
NPI:1932651502
Name:REYNOSO, JULIA KAOHE (LMFT)
Entity type:Individual
Prefix:MRS
First Name:JULIA
Middle Name:KAOHE
Last Name:REYNOSO
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1130 E CLARK AVE STE 150-241
Mailing Address - Street 2:
Mailing Address - City:SANTA MARIA
Mailing Address - State:CA
Mailing Address - Zip Code:93455-5178
Mailing Address - Country:US
Mailing Address - Phone:805-270-5602
Mailing Address - Fax:
Practice Address - Street 1:1130 E CLARK AVE STE 150-241
Practice Address - Street 2:
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93455-5178
Practice Address - Country:US
Practice Address - Phone:805-270-5602
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-31
Last Update Date:2025-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAIMF96255106H00000X
CALMFT119250106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist