Provider Demographics
NPI:1043374770
Name:PHILIPP, JULIAN LESSING (MFT)
Entity Type:Individual
Prefix:MR
First Name:JULIAN
Middle Name:LESSING
Last Name:PHILIPP
Suffix:
Gender:M
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1309 EVANS
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:AR
Mailing Address - Zip Code:94124
Mailing Address - Country:US
Mailing Address - Phone:415-206-7655
Mailing Address - Fax:
Practice Address - Street 1:1309 EVANS AVE
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94124-1705
Practice Address - Country:US
Practice Address - Phone:415-206-7655
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA37197106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist