Provider Demographics
NPI:1649243510
Name:HOLLARN, JULIE A (LCSW)
Entity Type:Individual
Prefix:MS
First Name:JULIE
Middle Name:A
Last Name:HOLLARN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2934 MURAT ST
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92117-2446
Mailing Address - Country:US
Mailing Address - Phone:858-272-2309
Mailing Address - Fax:858-279-6154
Practice Address - Street 1:4550 KEARNY VILLA RD
Practice Address - Street 2:SUITE 116
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123-1578
Practice Address - Country:US
Practice Address - Phone:858-279-1223
Practice Address - Fax:858-279-6154
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-09
Last Update Date:2010-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS119411041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASW11941BMedicare ID - Type Unspecified