Provider Demographics
NPI:1831235514
Name:VAN SCHOOR, JULIANNE STOLL (MD)
Entity type:Individual
Prefix:
First Name:JULIANNE
Middle Name:STOLL
Last Name:VAN SCHOOR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1310 PRENTICE DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:HEALDSBURG
Mailing Address - State:CA
Mailing Address - Zip Code:95448-3384
Mailing Address - Country:US
Mailing Address - Phone:707-473-8445
Mailing Address - Fax:707-473-8451
Practice Address - Street 1:1310 PRENTICE DR
Practice Address - Street 2:SUITE A
Practice Address - City:HEALDSBURG
Practice Address - State:CA
Practice Address - Zip Code:95448-3384
Practice Address - Country:US
Practice Address - Phone:707-473-8445
Practice Address - Fax:707-473-8451
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2024-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY576632084P0800X
CAA609812084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CABS5347174OtherDEA #
CAA60981Medicare UPIN