MEDICARE: MS. JULIE A. HOLLARN 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
1	1041C0700X	Clinical Social Worker	LCS11941	CA

General Provider Information

NPI Number	:	1649243510
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JULIE A. HOLLARN LCSW

Provider Business Mailing Address
First Line	:	2934 MURAT ST
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92117-2446
Country	:	US
Telephone Number	:	858-272-2309
Fax Number	:	858-279-6154

Provider Business Practice Location Address
First Line	:	4550 KEARNY VILLA RD
Second Line	:	SUITE 116
City	:	SAN DIEGO
State	:	CA
Zip	:	92123-1578
Country	:	US
Telephone Number	:	858-279-1223
Fax Number	:	858-279-6154

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

Provider Enumeration Date	:	02/09/2006
Last Update Date	:	10/06/2010

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