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NPI Code Detail

MEDICARE: JULIAN ANDREW SHIPNUCK ASW

MEDICARE:   JULIAN ANDREW SHIPNUCK  ASW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health CounselorASW134007CA

General Provider Information

NPI Number : 1588536221
Entity Type Code : Individual
Provider Name (Legal Business Name) : JULIAN ANDREW SHIPNUCK ASW
Provider Business Mailing Address
First Line : 1000 42ND ST
Second Line :
City : OAKLAND
State : CA
Zip : 94608-3621
Country : US
Telephone Number : 510-452-2063
Fax Number :
Provider Business Practice Location Address
First Line : 2501 CHESTNUT ST
Second Line :
City : OAKLAND
State : CA
Zip : 94607-2477
Country : US
Telephone Number : 510-452-2063
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/22/2025
Last Update Date : 09/22/2025

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Directions to “ JULIAN ANDREW SHIPNUCK ASW” Practice Location

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