Provider Demographics
NPI:1811928070
Name:ORLOV, JULIE (MSW, MAOL)
Entity type:Individual
Prefix:MS
First Name:JULIE
Middle Name:
Last Name:ORLOV
Suffix:
Gender:F
Credentials:MSW, MAOL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 312
Mailing Address - Street 2:
Mailing Address - City:IDYLLWILD
Mailing Address - State:CA
Mailing Address - Zip Code:92549-0312
Mailing Address - Country:US
Mailing Address - Phone:310-379-5855
Mailing Address - Fax:951-527-0023
Practice Address - Street 1:54240 RIDGEVIEW DR
Practice Address - Street 2:SUITE 202
Practice Address - City:IDYLLWILD
Practice Address - State:CA
Practice Address - Zip Code:92549
Practice Address - Country:US
Practice Address - Phone:310-379-5855
Practice Address - Fax:951-527-0023
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-06
Last Update Date:2018-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS14902101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASW14902Medicare ID - Type Unspecified