MEDICARE: DR. JOSE JAVIER JUAREZ, PSY.D.

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
2	103TC0700X	Clinical Psychologist

General Provider Information

NPI Number	:	1215407341
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DR. JOSE JAVIER JUAREZ, PSY.D.

Provider Business Mailing Address
First Line	:	444 W OCEAN BLVD STE 800
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90802-4529
Country	:	US
Telephone Number	:	818-634-4783
Fax Number	:

Provider Business Practice Location Address
First Line	:	550 S PALOS VERDES ST #559
Second Line	:
City	:	SAN PEDRO
State	:	CA
Zip	:	90731
Country	:	US
Telephone Number	:	818-634-4783
Fax Number	:

Authorized Official
Title or Position	:	CHIEF EXECUTIVE OFFICER
Name	:	DR. JOSE JAVIER URIZAR JUAREZ
Credential	:	PSY.D.
Telephone Number	:	818-634-4783

Provider Enumeration Date	:	12/02/2018
Last Update Date	:	03/16/2026

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