Provider Demographics
NPI:1356465959
Name:ROBERTSON, JULIA (MSW)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:
Last Name:ROBERTSON
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:PO BOX 1497
Mailing Address - Street 2:
Mailing Address - City:NEVADA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:95959-1497
Mailing Address - Country:US
Mailing Address - Phone:530-477-9121
Mailing Address - Fax:
Practice Address - Street 1:500 CROWN POINT CIR
Practice Address - Street 2:SUITE 120
Practice Address - City:GRASS VALLEY
Practice Address - State:CA
Practice Address - Zip Code:95945-9514
Practice Address - Country:US
Practice Address - Phone:530-470-2557
Practice Address - Fax:530-271-0257
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-19
Last Update Date:2009-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS 217761041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical