Provider Demographics
NPI:1801371760
Name:KLEIN, JULIA D (BCBA)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:D
Last Name:KLEIN
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:710 ROCKPORT CT
Mailing Address - Street 2:
Mailing Address - City:TRACY
Mailing Address - State:CA
Mailing Address - Zip Code:95377-9016
Mailing Address - Country:US
Mailing Address - Phone:209-321-8191
Mailing Address - Fax:
Practice Address - Street 1:710 ROCKPORT CT
Practice Address - Street 2:
Practice Address - City:TRACY
Practice Address - State:CA
Practice Address - Zip Code:95377-9016
Practice Address - Country:US
Practice Address - Phone:209-321-8191
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-26
Last Update Date:2022-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1-18-31590103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst