Healthcare Provider Details

I. General information

NPI: 1659925022
Provider Name (Legal Business Name): JULIA KRISTINE MORENO-VEGA LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/24/2019
Last Update Date: 07/10/2025
Certification Date: 07/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1055 W HENDERSON AVE STE 2
PORTERVILLE CA
93257-1490
US

IV. Provider business mailing address

1055 W HENDERSON AVE STE 2
PORTERVILLE CA
93257-1490
US

V. Phone/Fax

Practice location:
  • Phone: 559-788-1200
  • Fax: 559-713-3717
Mailing address:
  • Phone: 559-788-1200
  • Fax: 559-713-3717

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number114533
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number155262
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: