Provider Demographics
NPI:1174221444
Name:RESULTAN, JULIA CHIONG
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:CHIONG
Last Name:RESULTAN
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 1:95 3RD ST FL 2
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94103-3103
Mailing Address - Country:US
Mailing Address - Phone:415-813-2204
Mailing Address - Fax:772-675-9100
Practice Address - Street 1:95 3RD ST FL 2
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94103-3103
Practice Address - Country:US
Practice Address - Phone:415-813-2204
Practice Address - Fax:772-675-9100
Is Sole Proprietor?:No
Enumeration Date:2023-02-16
Last Update Date:2023-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA106E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst