Provider Demographics
NPI:1891670840
Name:FOOT, JULIE (PPS)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:FOOT
Suffix:
Gender:F
Credentials:PPS
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:ROSE
Other - Last Name:KAPLAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PPS
Mailing Address - Street 1:4112 CERRITOS AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ALAMITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90720-2521
Mailing Address - Country:US
Mailing Address - Phone:714-816-3320
Mailing Address - Fax:
Practice Address - Street 1:4112 CERRITOS AVE
Practice Address - Street 2:
Practice Address - City:LOS ALAMITOS
Practice Address - State:CA
Practice Address - Zip Code:90720-2521
Practice Address - Country:US
Practice Address - Phone:714-816-3320
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-08
Last Update Date:2025-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA240086660103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool