Provider Demographics
NPI:1346595220
Name:BURLINGAME, JULIE S (MA, BCBA)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:S
Last Name:BURLINGAME
Suffix:
Gender:F
Credentials:MA, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11040 BOLLINGER CANYON RD STE E410
Mailing Address - Street 2:
Mailing Address - City:SAN RAMON
Mailing Address - State:CA
Mailing Address - Zip Code:94582-4969
Mailing Address - Country:US
Mailing Address - Phone:925-973-0279
Mailing Address - Fax:888-632-3191
Practice Address - Street 1:11040 BOLLINGER CANYON RD STE E410
Practice Address - Street 2:
Practice Address - City:SAN RAMON
Practice Address - State:CA
Practice Address - Zip Code:94582-4969
Practice Address - Country:US
Practice Address - Phone:925-973-0279
Practice Address - Fax:888-632-3191
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-17
Last Update Date:2020-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1-07-3471103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst