Provider Demographics
NPI:1346398989
Name:KULJIAN, PATRICIA ELLEN (PHD)
Entity type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:ELLEN
Last Name:KULJIAN
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 1:1220 UNIVERSITY DR
Mailing Address - Street 2:SUITE 201
Mailing Address - City:MENLO PARK
Mailing Address - State:CA
Mailing Address - Zip Code:94025-4262
Mailing Address - Country:US
Mailing Address - Phone:650-473-6993
Mailing Address - Fax:
Practice Address - Street 1:1220 UNIVERSITY DR
Practice Address - Street 2:SUITE 201
Practice Address - City:MENLO PARK
Practice Address - State:CA
Practice Address - Zip Code:94025-4262
Practice Address - Country:US
Practice Address - Phone:650-473-6993
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY15526103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist