Provider Demographics
NPI:1073759213
Name:KAUFFMAN, JULIANN EVA (EDD)
Entity Type:Individual
Prefix:DR
First Name:JULIANN
Middle Name:EVA
Last Name:KAUFFMAN
Suffix:
Gender:F
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 S MAIN ST STE 240
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94596-8811
Mailing Address - Country:US
Mailing Address - Phone:925-274-1477
Mailing Address - Fax:925-283-5615
Practice Address - Street 1:3484 MONROE AVE
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:CA
Practice Address - Zip Code:94549-4521
Practice Address - Country:US
Practice Address - Phone:925-274-1477
Practice Address - Fax:925-283-5615
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-17
Last Update Date:2021-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA17331103TC0700X, 103TC2200X, 103TB0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0PL173310Medicare PIN