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General NPI Number Information
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NPI Number | 1629177621
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Entity Type | Individual
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Provider Name | JUDITH ITURRIAGA PH.D., M.F.T.
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Gender | Female
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Dates
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Enumeration Date | 09/22/2006
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Last Update Date | 09/15/2008
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Provider Practice Location Address
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Address Line | 909 ELECTRIC AVE STE 302
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City | SEAL BEACH
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State | CA
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Zip | 90740-6336
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Country | US
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Telephone | 562-799-3830
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Fax | 714-622-4283
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Provider Business Mailing Address
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Address Line | 15202 HANOVER LN
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City | HUNTINGTON BEACH
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State | CA
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Zip | 92647-2628
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Country | US
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Telephone | 714-622-4282
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Fax | 714-622-4283
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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 | MFT15900
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License Number State | CA
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