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General NPI Number Information
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NPI Number | 1730513771
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Entity Type | Individual
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Provider Name | JULISSA YVONNE CORTES PSY.D.
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Gender | Female
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Dates
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Enumeration Date | 08/27/2013
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Last Update Date | 09/27/2024
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Provider Practice Location Address
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Address Line | 601 E GLENOAKS BLVD STE 102
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City | GLENDALE
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State | CA
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Zip | 91207-1780
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Country | US
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Telephone | 310-375-4855
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Fax |
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Provider Business Mailing Address
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Address Line | 3718 ROSELAWN AVE APT 1
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City | GLENDALE
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State | CA
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Zip | 91208-1149
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Country | US
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Telephone | 213-249-5468
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | CAPSY34400
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License Number State | CA
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