Provider Demographics
NPI:1730346693
Name:HARRIS-JUNGE, RHEA ROSE
Entity type:Individual
Prefix:MS
First Name:RHEA
Middle Name:ROSE
Last Name:HARRIS-JUNGE
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:RHEA
Other - Middle Name:ROSE
Other - Last Name:MULLINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MFT
Mailing Address - Street 1:2706 HONOLULU AVE APT 302
Mailing Address - Street 2:
Mailing Address - City:MONTROSE
Mailing Address - State:CA
Mailing Address - Zip Code:91020-1753
Mailing Address - Country:US
Mailing Address - Phone:818-618-8674
Mailing Address - Fax:
Practice Address - Street 1:2706 HONOLULU AVE
Practice Address - Street 2:302
Practice Address - City:MONTROSE
Practice Address - State:CA
Practice Address - Zip Code:91020-1750
Practice Address - Country:US
Practice Address - Phone:818-618-8674
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-19
Last Update Date:2016-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC28461101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health