Provider Demographics
NPI:1225169725
Name:GRANT, JULIA LYNN (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:JULIA
Middle Name:LYNN
Last Name:GRANT
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8177 MORGAN HILL WAY
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95828-6365
Mailing Address - Country:US
Mailing Address - Phone:916-681-0965
Mailing Address - Fax:
Practice Address - Street 1:3050 FITE CIR
Practice Address - Street 2:STE 204
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95827-1807
Practice Address - Country:US
Practice Address - Phone:916-600-7887
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-08
Last Update Date:2019-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA195171041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA19517OtherL.C.S.W. LICENSE NUMBER
CA11702176OtherCAQH PROVIDER #
CA9942OtherPLACER COUNTY PROVIDER #
AR383319OtherMHN 'PIN' NUMBER