Provider Demographics
NPI:1720856180
Name:SAVAGE, JULIE ANN (MA)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:ANN
Last Name:SAVAGE
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2460 PARK BLVD STE 6
Mailing Address - Street 2:
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94306-1917
Mailing Address - Country:US
Mailing Address - Phone:669-241-0913
Mailing Address - Fax:650-695-0995
Practice Address - Street 1:2460 PARK BLVD STE 6
Practice Address - Street 2:
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94306-1917
Practice Address - Country:US
Practice Address - Phone:669-241-0913
Practice Address - Fax:650-695-0995
Is Sole Proprietor?:No
Enumeration Date:2023-12-15
Last Update Date:2023-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA142233106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist