Healthcare Provider Details

I. General information

NPI: 1497609432
Provider Name (Legal Business Name): JULIA GOTHOLD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/25/2026
Last Update Date: 03/14/2026
Certification Date: 03/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1359 E. LASSE AVE.
CHICO CA
95973
US

IV. Provider business mailing address

4924 BALBOA BLVD UNIT A1043
ENCINO CA
91316-3402
US

V. Phone/Fax

Practice location:
  • Phone: 230-230-9230
  • Fax: 530-466-3154
Mailing address:
  • Phone: 747-213-2294
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number159727
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: