Provider Demographics
NPI:1174840086
Name:MYERS, JULIA A (PSY D)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:A
Last Name:MYERS
Suffix:
Gender:F
Credentials:PSY D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2907 SHELTER ISLAND DR
Mailing Address - Street 2:STE 105; #303
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92106-2743
Mailing Address - Country:US
Mailing Address - Phone:858-414-1079
Mailing Address - Fax:
Practice Address - Street 1:240 9TH ST
Practice Address - Street 2:
Practice Address - City:DEL MAR
Practice Address - State:CA
Practice Address - Zip Code:92014-2717
Practice Address - Country:US
Practice Address - Phone:858-414-1079
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-01
Last Update Date:2015-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 23354103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical