MEDICARE: JULISSA RAZO M.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	48836	CA

General Provider Information

NPI Number	:	1013041672
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULISSA RAZO M.S.

Provider Business Mailing Address
First Line	:	5200 CLARK AVE
Second Line	:	P.O. BOX 6341
City	:	LAKEWOOD
State	:	CA
Zip	:	90714
Country	:	US
Telephone Number	:	562-900-6314
Fax Number	:

Provider Business Practice Location Address
First Line	:	7080 HOLLYWOOD BLVD STE 815
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90028-6935
Country	:	US
Telephone Number	:	562-900-6413
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/15/2007
Last Update Date	:	05/29/2025

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