Basic Information
Provider Information
NPI: 1407131287
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: PARMER
FirstName: JULIA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: ACSW
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 5676 RIVERDALE AVENUE STE 202
Address2:  
City: BRONX
State: NY
PostalCode: 10471
CountryCode: US
TelephoneNumber: 7187965300
FaxNumber: 7185481161
Practice Location
Address1: 2686 SPRING ST
Address2:  
City: REDWOOD CITY
State: CA
PostalCode: 940633522
CountryCode: US
TelephoneNumber: 6503683345
FaxNumber: 5108790354
Other Information
ProviderEnumerationDate: 10/12/2011
LastUpdateDate: 07/21/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
1041C0700X  N Behavioral Health & Social Service ProvidersSocial WorkerClinical
1041C0700X67267CAY Behavioral Health & Social Service ProvidersSocial WorkerClinical

No ID Information.


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