Healthcare Provider Details

I. General information

NPI: 1457631939
Provider Name (Legal Business Name): JULIE ILENE HEY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/28/2011
Last Update Date: 12/20/2024
Certification Date: 12/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3569 SHURTLEFF CT
LOS ANGELES CA
90065-2427
US

IV. Provider business mailing address

3569 SHURTLEFF CT
LOS ANGELES CA
90065-2427
US

V. Phone/Fax

Practice location:
  • Phone: 213-500-6921
  • Fax:
Mailing address:
  • Phone: 213-500-6921
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number83787
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: