Healthcare Provider Details

I. General information

NPI: 1831028422
Provider Name (Legal Business Name): JUDITH MCCORD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/18/2026
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

867 ATCHISON ST
PASADENA CA
91104-2314
US

IV. Provider business mailing address

701 ADELYN DR
SAN GABRIEL CA
91775-2803
US

V. Phone/Fax

Practice location:
  • Phone: 626-798-0915
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberLMFT25678
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: