Provider Demographics
NPI:1255481016
Name:PATRUSKY, JULIE M (PHD)
Entity Type:Individual
Prefix:DR
First Name:JULIE
Middle Name:M
Last Name:PATRUSKY
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 1:1034 ORDWAY ST
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:CA
Mailing Address - Zip Code:94706-2523
Mailing Address - Country:US
Mailing Address - Phone:510-528-0299
Mailing Address - Fax:
Practice Address - Street 1:1034 ORDWAY ST
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:CA
Practice Address - Zip Code:94706-2523
Practice Address - Country:US
Practice Address - Phone:510-528-0299
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-11
Last Update Date:2008-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health