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General NPI Number Information
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NPI Number | 1265887822
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Entity Type | Organization
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Legal Business Name | COMPASS TREATMENT CENTER, A MARRIAGE AND FAMILY THERAPY CORPORATION
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Dates
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Enumeration Date | 05/02/2016
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Last Update Date | 02/15/2019
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Provider Practice Location Address
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Address Line | 10200 SEPULVEDA BLVD STE 180
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City | MISSION HILLS
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State | CA
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Zip | 91345-2654
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Country | US
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Telephone | 818-672-6338
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Fax | 818-698-6555
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Provider Business Mailing Address
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Address Line | 10200 SEPULVEDA BLVD STE 180
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City | MISSION HILLS
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State | CA
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Zip | 91345-2654
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Country | US
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Telephone | 818-672-6338
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. MARY JANE JULIUS
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Credential | PSYD
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Telephone | 818-672-6338
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PSY 25196
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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 | MFC 47695
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MFC 51214
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License Number State | CA
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