Provider Demographics
NPI:1427833953
Name:BRAVIN, JULIA ISABELA (PHD)
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:ISABELA
Last Name:BRAVIN
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 1:733 5TH AVE APT 5
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94118-3962
Mailing Address - Country:US
Mailing Address - Phone:202-607-3491
Mailing Address - Fax:
Practice Address - Street 1:3260 ASH ST
Practice Address - Street 2:
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94306-2239
Practice Address - Country:US
Practice Address - Phone:415-610-7278
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-31
Last Update Date:2023-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA34277103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical