Provider Demographics
NPI:1619336039
Name:LUBAN, JULIA
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:
Last Name:LUBAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:209 PINOT CT
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95119-1855
Mailing Address - Country:US
Mailing Address - Phone:408-221-8642
Mailing Address - Fax:
Practice Address - Street 1:209 PINOT CT
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95119-1855
Practice Address - Country:US
Practice Address - Phone:408-221-8642
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-12
Last Update Date:2016-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator