Healthcare Provider Details

I. General information

NPI: 1528839875
Provider Name (Legal Business Name): JULIE ANN GUTHRIE M.S., BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/15/2024
Last Update Date: 01/15/2024
Certification Date: 01/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3491 ELM AVE
LONG BEACH CA
90807-4430
US

IV. Provider business mailing address

4126 E 5TH ST
LONG BEACH CA
90814-1738
US

V. Phone/Fax

Practice location:
  • Phone: 833-223-8326
  • Fax:
Mailing address:
  • Phone: 714-356-3811
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-24-70636
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: