Individual
JULIE HERIFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPT
Contact information
Practice address
2180 JOHNSON AVE, SAN LUIS OBISPO, CA 93401-4558
(805) 781-4753
Mailing address
2180 JOHNSON AVE, SAN LUIS OBISPO, CA 93401-4558
(805) 781-4753
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
PT28093
CA
Other
Enumeration date
03/06/2017
Last updated
03/09/2017
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