Healthcare Provider Details

I. General information

NPI: 1124082565
Provider Name (Legal Business Name): JULIE S HAHN PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/13/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1620 ALPINE BLVD #211
ALPINE CA
91901-1102
US

IV. Provider business mailing address

10250 CAMINITO CUERVO #25
SAN DIEGO CA
92108-1800
US

V. Phone/Fax

Practice location:
  • Phone: 619-445-0600
  • Fax: 866-273-2035
Mailing address:
  • Phone: 619-445-0600
  • Fax: 866-273-2035

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY 14827
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: