Provider Demographics
NPI:1699156893
Name:BARULICH, MIKELA JEAN
Entity type:Individual
Prefix:MS
First Name:MIKELA
Middle Name:JEAN
Last Name:BARULICH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 13TH ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94103-2461
Mailing Address - Country:US
Mailing Address - Phone:415-241-1184
Mailing Address - Fax:415-241-1176
Practice Address - Street 1:211 13TH ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94103-2461
Practice Address - Country:US
Practice Address - Phone:650-455-7635
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-12
Last Update Date:2015-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor