MEDICARE: MISS JULIA MICHELLE MARINO AMFT

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	144017	CA

General Provider Information

NPI Number	:	1184495350
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS JULIA MICHELLE MARINO AMFT

Provider Business Mailing Address
First Line	:	PO BOX 4383
Second Line	:
City	:	WEST HILLS
State	:	CA
Zip	:	91308-4383
Country	:	US
Telephone Number	:	818-522-6953
Fax Number	:

Provider Business Practice Location Address
First Line	:	PO BOX 4383
Second Line	:
City	:	WEST HILLS
State	:	CA
Zip	:	91308-4383
Country	:	US
Telephone Number	:	818-522-6953
Fax Number	:

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

Provider Enumeration Date	:	01/15/2024
Last Update Date	:	01/12/2026

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