Provider Demographics
NPI:1801009329
Name:LEADER, JULIE BETH (PHD)
Entity Type:Individual
Prefix:DR
First Name:JULIE
Middle Name:BETH
Last Name:LEADER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:
Other - Last Name:LEADER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHD
Mailing Address - Street 1:3969 BROOKLINE WAY
Mailing Address - Street 2:
Mailing Address - City:EMERALD HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:94062
Mailing Address - Country:US
Mailing Address - Phone:650-260-0070
Mailing Address - Fax:
Practice Address - Street 1:611 VETERANS BLVD
Practice Address - Street 2:SUITE 102
Practice Address - City:REDWOOD CITY
Practice Address - State:CA
Practice Address - Zip Code:94063
Practice Address - Country:US
Practice Address - Phone:650-260-0070
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-08
Last Update Date:2022-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY17321103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical