Provider Demographics
NPI:1679314306
Name:HART, JULIA N (MA ED PPS)
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:N
Last Name:HART
Suffix:
Gender:F
Credentials:MA ED PPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 SOLANO AVE
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:CA
Mailing Address - Zip Code:94706-1725
Mailing Address - Country:US
Mailing Address - Phone:510-558-3750
Mailing Address - Fax:
Practice Address - Street 1:1200 SOLANO AVE
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:CA
Practice Address - Zip Code:94706-1725
Practice Address - Country:US
Practice Address - Phone:510-558-3750
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-05
Last Update Date:2024-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20089674103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool