Healthcare Provider Details

I. General information

NPI: 1841438066
Provider Name (Legal Business Name): JULIE LYNN HARRIS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/26/2009
Last Update Date: 01/26/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1275 MISSION ST
SAN FRANCISCO CA
94103-2705
US

IV. Provider business mailing address

1828 COMSTOCK LN
SAN JOSE CA
95124-1704
US

V. Phone/Fax

Practice location:
  • Phone: 415-905-5050
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: