Healthcare Provider Details

I. General information

NPI: 1700777430
Provider Name (Legal Business Name): JULIA MORGAN IANNUCCI WARREN PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2025
Last Update Date: 07/11/2025
Certification Date: 07/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

409 BAYSHORE BLVD
TAMPA FL
33606-2707
US

IV. Provider business mailing address

1115 3RD AVE E UNIT 2401
BRADENTON FL
34208-1392
US

V. Phone/Fax

Practice location:
  • Phone: 813-844-3101
  • Fax:
Mailing address:
  • Phone: 929-400-3376
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TH0004X
TaxonomyHealth Psychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: