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General NPI Number Information
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NPI Number | 1790209906
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Entity Type | Organization
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Legal Business Name | JULIE RAYHANABAD, PH.D., A PSYCHOLOGICAL CORPORATION
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Dates
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Enumeration Date | 07/29/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 14708 PIPELINE AVE STE B
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City | CHINO HILLS
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State | CA
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Zip | 91709-1296
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Country | US
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Telephone | 909-393-8585
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Fax | 909-393-8566
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Provider Business Mailing Address
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Address Line | 3851 KATELLA AVE STE 375
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City | LOS ALAMITOS
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State | CA
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Zip | 90720-3377
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Country | US
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Telephone | 909-258-4482
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Fax | 909-393-8566
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Authorized Official
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Title or Position | CLINICAL PSYCHOLOGIST
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Name | DR. JULIE RAYHANABAD
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Credential | PH.D.
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Telephone | 909-258-4482
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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 | PSY29047
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License Number State | CA
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