Provider Demographics
NPI:1295166585
Name:BOGDANSKI, JULIE (LAC)
Entity type:Individual
Prefix:MISS
First Name:JULIE
Middle Name:
Last Name:BOGDANSKI
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:230 GRAND AVE
Mailing Address - Street 2:SUITE #301C
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94610-4589
Mailing Address - Country:US
Mailing Address - Phone:510-387-0852
Mailing Address - Fax:
Practice Address - Street 1:230 GRAND AVE
Practice Address - Street 2:SUITE #301C
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94610-4589
Practice Address - Country:US
Practice Address - Phone:510-387-0852
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-11
Last Update Date:2013-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA15840171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist