Provider Demographics
NPI:1225047475
Name:LALOR, JULIE B (PHD)
Entity Type:Individual
Prefix:DR
First Name:JULIE
Middle Name:B
Last Name:LALOR
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8772 CUYAMACA ST
Mailing Address - Street 2:SUITE 104
Mailing Address - City:SANTEE
Mailing Address - State:CA
Mailing Address - Zip Code:92071-4218
Mailing Address - Country:US
Mailing Address - Phone:619-600-7658
Mailing Address - Fax:619-448-8586
Practice Address - Street 1:8772 CUYAMACA ST
Practice Address - Street 2:SUITE 104
Practice Address - City:SANTEE
Practice Address - State:CA
Practice Address - Zip Code:92071-4218
Practice Address - Country:US
Practice Address - Phone:619-600-7658
Practice Address - Fax:619-448-8586
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-05
Last Update Date:2014-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 19986103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACP 19986Medicaid