Provider Demographics
NPI:1750413712
Name:CONNELLA, JULIE STERES (MFT)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:STERES
Last Name:CONNELLA
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:F
Other - Last Name:STERES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MFT
Mailing Address - Street 1:10811 WASHINGTON BLVD
Mailing Address - Street 2:SUITE 280
Mailing Address - City:CULVER CITY
Mailing Address - State:CA
Mailing Address - Zip Code:90232-3659
Mailing Address - Country:US
Mailing Address - Phone:310-452-3000
Mailing Address - Fax:
Practice Address - Street 1:10811 WASHINGTON BLVD
Practice Address - Street 2:SUITE 280
Practice Address - City:CULVER CITY
Practice Address - State:CA
Practice Address - Zip Code:90232-3659
Practice Address - Country:US
Practice Address - Phone:310-452-3000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-12
Last Update Date:2013-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC17603106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist