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General NPI Number Information
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NPI Number | 1053814004
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Entity Type | Individual
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Provider Name | JULIE M VEZINA LMFT
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Gender | Female
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Dates
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Enumeration Date | 03/16/2018
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Last Update Date | 11/03/2021
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Provider Practice Location Address
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Address Line | 15455 SAN FERNANDO MISSION BLVD STE 300
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City | MISSION HILLS
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State | CA
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Zip | 91345-1353
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Country | US
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Telephone | 747-245-5049
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Fax |
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Provider Business Mailing Address
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Address Line | 15455 SAN FERNANDO MISSION BLVD STE 300
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City | MISSION HILLS
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State | CA
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Zip | 91345-1353
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Country | US
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Telephone | 747-245-5049
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 101720
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 114601
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License Number State | CA
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