Provider Demographics
NPI:1629125521
Name:KRIEGLER, JULIE A (PHD)
Entity Type:Individual
Prefix:DR
First Name:JULIE
Middle Name:A
Last Name:KRIEGLER
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:PO BOX 2487
Mailing Address - Street 2:
Mailing Address - City:EL GRANADA
Mailing Address - State:CA
Mailing Address - Zip Code:94018
Mailing Address - Country:US
Mailing Address - Phone:650-566-9920
Mailing Address - Fax:650-321-8423
Practice Address - Street 1:711 MAIN ST
Practice Address - Street 2:
Practice Address - City:HALF MOON BAY
Practice Address - State:CA
Practice Address - Zip Code:94019
Practice Address - Country:US
Practice Address - Phone:650-566-9920
Practice Address - Fax:650-321-8423
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-04
Last Update Date:2022-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY11473103T00000X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist