Provider Demographics
NPI:1154011658
Name:COOK, JULIANE KATHRYN (PHD)
Entity type:Individual
Prefix:DR
First Name:JULIANE
Middle Name:KATHRYN
Last Name:COOK
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 1:2040 SOLANO WAY UNIT 2
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94606-4935
Mailing Address - Country:US
Mailing Address - Phone:760-542-5315
Mailing Address - Fax:
Practice Address - Street 1:1840 SAN MIGUEL DR STE 207
Practice Address - Street 2:
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94596-4912
Practice Address - Country:US
Practice Address - Phone:760-542-5315
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-09
Last Update Date:2023-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSB94027481103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling