Healthcare Provider Details

I. General information

NPI: 1649428715
Provider Name (Legal Business Name): JULIE MICHELLE SCHMIDT LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/03/2008
Last Update Date: 09/03/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

625 S MCCLELLAND ST
SANTA MARIA CA
93454-5120
US

IV. Provider business mailing address

625 S MCCLELLAND ST
SANTA MARIA CA
93454-5120
US

V. Phone/Fax

Practice location:
  • Phone: 805-614-9535
  • Fax: 805-614-9390
Mailing address:
  • Phone: 805-614-9535
  • Fax: 805-614-9390

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number41096
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: