Provider Demographics
NPI:1225239361
Name:REISMAN, JULIA KARYL (LCSW, BCD)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:KARYL
Last Name:REISMAN
Suffix:
Gender:F
Credentials:LCSW, BCD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4455 CONCHITA WAY
Mailing Address - Street 2:
Mailing Address - City:TARZANA
Mailing Address - State:CA
Mailing Address - Zip Code:91356-4901
Mailing Address - Country:US
Mailing Address - Phone:818-719-2844
Mailing Address - Fax:818-719-2494
Practice Address - Street 1:5601 DE SOTO AVENUE
Practice Address - Street 2:
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91367
Practice Address - Country:US
Practice Address - Phone:818-719-2844
Practice Address - Fax:818-719-2494
Is Sole Proprietor?:No
Enumeration Date:2007-05-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS202601041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical