MEDICARE: JULIA SUMNER YARRINGTON HARTLEY PH.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	103TC0700X	Clinical Psychologist	36378	CA

General Provider Information

NPI Number	:	1548085210
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIA SUMNER YARRINGTON HARTLEY PH.D.

Provider Business Mailing Address
First Line	:	1201 MONTANA AVE STE 201
Second Line	:
City	:	SANTA MONICA
State	:	CA
Zip	:	90403-1762
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1201 MONTANA AVE STE 201
Second Line	:
City	:	SANTA MONICA
State	:	CA
Zip	:	90403-1762
Country	:	US
Telephone Number	:	585-402-3994
Fax Number	:

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

Provider Enumeration Date	:	11/18/2024
Last Update Date	:	12/05/2025

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