Provider Demographics
NPI:1205032083
Name:JALALAT, JULIA (MSW)
Entity Type:Individual
Prefix:MISS
First Name:JULIA
Middle Name:
Last Name:JALALAT
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:555 PIERCE ST
Mailing Address - Street 2:#640
Mailing Address - City:ALBANY
Mailing Address - State:CA
Mailing Address - Zip Code:94706-1044
Mailing Address - Country:US
Mailing Address - Phone:510-528-5040
Mailing Address - Fax:
Practice Address - Street 1:2850 WEST ST
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94608-4536
Practice Address - Country:US
Practice Address - Phone:510-879-8481
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA158451041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical