Provider Demographics
NPI:1144512997
Name:BACHITT, JULIANNA MARIE (CAADACI​594013)
Entity type:Individual
Prefix:
First Name:JULIANNA
Middle Name:MARIE
Last Name:BACHITT
Suffix:
Gender:F
Credentials:CAADACI​594013
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1320 VAN BEURDEN DR
Mailing Address - Street 2:103
Mailing Address - City:LOS OSOS
Mailing Address - State:CA
Mailing Address - Zip Code:93402-3380
Mailing Address - Country:US
Mailing Address - Phone:805-689-8024
Mailing Address - Fax:805-689-8024
Practice Address - Street 1:1320 VAN BEURDEN DR
Practice Address - Street 2:103
Practice Address - City:LOS OSOS
Practice Address - State:CA
Practice Address - Zip Code:93402-3380
Practice Address - Country:US
Practice Address - Phone:805-689-8024
Practice Address - Fax:805-689-8024
Is Sole Proprietor?:No
Enumeration Date:2011-05-12
Last Update Date:2013-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CACAADACI​594013101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program