Provider Demographics
NPI:1205925617
Name:GOLDMAN-PHELPS, JULIA
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:
Last Name:GOLDMAN-PHELPS
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 1:3150 EL CAMINO REAL
Mailing Address - Street 2:SUITE C
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92008-2110
Mailing Address - Country:US
Mailing Address - Phone:760-390-1996
Mailing Address - Fax:760-941-7823
Practice Address - Street 1:3150 EL CAMINO REAL
Practice Address - Street 2:SUITE C
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92008-2110
Practice Address - Country:US
Practice Address - Phone:760-390-1996
Practice Address - Fax:760-941-7823
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-12
Last Update Date:2011-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS139461041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical