Provider Demographics
NPI:1851697205
Name:TRIM, JULIE (PHD)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:TRIM
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 1:4510 EXECUTIVE DR
Mailing Address - Street 2:SUITE 315
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92121-3021
Mailing Address - Country:US
Mailing Address - Phone:858-534-7719
Mailing Address - Fax:
Practice Address - Street 1:4510 EXECUTIVE DR
Practice Address - Street 2:SUITE 315
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92121-3021
Practice Address - Country:US
Practice Address - Phone:858-534-7719
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-02
Last Update Date:2013-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 22814103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical