Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC2200X | Clinical Child & Adolescent Psychologist | PSY32388 | CA |
NPI | 1134509391 |
---|---|
Provider Name | Dr. Julia Revillion Cox |
First Address | Los Angeles, CA 90024-5055 |
Second Address | Los Angeles, CA 90024-5055 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/06/2015 |
Last Update Date | 24/09/2021 |