MEDICARE: JULIE COMART

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
1	390200000X	Student in an Organized Health Care Education/Training Program
2	1041C0700X	Clinical Social Worker	94409	CA

General Provider Information

NPI Number	:	1467821397
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIE COMART

Provider Business Mailing Address
First Line	:	11 FAIRBANKS ST
Second Line	:	APT 1
City	:	BRIGHTON
State	:	MA
Zip	:	02135-2503
Country	:	US
Telephone Number	:	207-441-0415
Fax Number	:

Provider Business Practice Location Address
First Line	:	4882 FELTON ST
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92116-1830
Country	:	US
Telephone Number	:	207-441-0415
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/22/2015
Last Update Date	:	02/06/2023

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Directions to “ JULIE COMART ” Practice Location

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