Healthcare Provider Details

I. General information

NPI: 1013847680
Provider Name (Legal Business Name): JULIA ELIN KWIAT WADSWORTH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JULIA ELIN KWIAT

II. Dates (important events)

Enumeration Date: 05/22/2026
Last Update Date: 05/22/2026
Certification Date: 05/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 542
NICASIO CA
94946-0542
US

IV. Provider business mailing address

PO BOX 542
NICASIO CA
94946-0542
US

V. Phone/Fax

Practice location:
  • Phone: 415-340-0337
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberAPCC21241
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberAMFT160743
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: