Provider Demographics
NPI:1659103505
Name:FREY, JULIE (MS, PPS)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:FREY
Suffix:
Gender:F
Credentials:MS, PPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4883 WOODTHRUSH RD
Mailing Address - Street 2:
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94566-4615
Mailing Address - Country:US
Mailing Address - Phone:925-337-0786
Mailing Address - Fax:
Practice Address - Street 1:VILLAGE HIGH SCHOOL
Practice Address - Street 2:4645 BERNAL AVENUE
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94566
Practice Address - Country:US
Practice Address - Phone:925-426-4260
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-19
Last Update Date:2024-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA240149310103TS0200X, 101YS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool
No103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool