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NPI Code Detail

MEDICARE: JULIE SPRUELL JEFFERY LCSW

MEDICARE: JULIE SPRUELL JEFFERY LCSW
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
11041C0700XClinical Social Worker70595CA

General Provider Information

NPI Number : 1275605529
Entity Type Code : Individual
Provider Name (Legal Business Name) : JULIE SPRUELL JEFFERY LCSW
Provider Business Mailing Address
First Line : 8459 BUCKLAND ST
Second Line :
City : LA MESA
State : CA
Zip : 91942-2883
Country : US
Telephone Number : 619-987-0395
Fax Number :
Provider Business Practice Location Address
First Line : 8459 BUCKLAND ST
Second Line :
City : LA MESA
State : CA
Zip : 91942-2883
Country : US
Telephone Number : 619-987-0395
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/14/2006
Last Update Date : 02/25/2019

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Directions to “ JULIE SPRUELL JEFFERY LCSW” Practice Location

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