Basic Information
| Provider Information | |||||||||
| NPI: | 1669796181 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BAAS | ||||||||
| FirstName: | JULIA | ||||||||
| MiddleName: | SUSANA SIU | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | L.C.S.W. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2051 JOHN JONES RD | ||||||||
| Address2: | |||||||||
| City: | DAVIS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 956169701 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5307582060 | ||||||||
| FaxNumber: | 5307588490 | ||||||||
| Practice Location | |||||||||
| Address1: | 2051 JOHN JONES RD | ||||||||
| Address2: | |||||||||
| City: | DAVIS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 956169701 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5307582060 | ||||||||
| FaxNumber: | 5307588490 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/26/2010 | ||||||||
| LastUpdateDate: | 12/17/2010 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | 26172 | CA | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.