Provider Demographics
NPI:1700933579
Name:LASHER, JULIE HAGMANN (PHD)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:HAGMANN
Last Name:LASHER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 33213
Mailing Address - Street 2:
Mailing Address - City:LOS GATOS
Mailing Address - State:CA
Mailing Address - Zip Code:95031-3213
Mailing Address - Country:US
Mailing Address - Phone:408-540-9296
Mailing Address - Fax:
Practice Address - Street 1:16443 SHADY VIEW LN
Practice Address - Street 2:
Practice Address - City:LOS GATOS
Practice Address - State:CA
Practice Address - Zip Code:95032-4722
Practice Address - Country:US
Practice Address - Phone:408-540-9296
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY14348103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0PL143480Medicare ID - Type Unspecified