Provider Demographics
NPI:1679772958
Name:SOOPIKIAN, JULIET H (MFT)
Entity type:Individual
Prefix:MS
First Name:JULIET
Middle Name:H
Last Name:SOOPIKIAN
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2633 LINCOLN BLVD
Mailing Address - Street 2:121
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90405-4619
Mailing Address - Country:US
Mailing Address - Phone:431-007-3520
Mailing Address - Fax:866-887-9003
Practice Address - Street 1:1314 WESTWOOD BLVD
Practice Address - Street 2:106
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90024-4902
Practice Address - Country:US
Practice Address - Phone:310-407-3520
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-16
Last Update Date:2007-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC38746106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist