Healthcare Provider Details

I. General information

NPI: 1629526850
Provider Name (Legal Business Name): JULIANA RISTA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/16/2016
Last Update Date: 06/19/2026
Certification Date: 06/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18411 CRENSHAW BLVD STE 407
TORRANCE CA
90504-5067
US

IV. Provider business mailing address

18411 CRENSHAW BLVD STE 407
TORRANCE CA
90504-5067
US

V. Phone/Fax

Practice location:
  • Phone: 323-481-0095
  • Fax:
Mailing address:
  • Phone: 323-481-0095
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number150528
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: