Provider Demographics
NPI:1871623017
Name:LAWRENCE, JULIAN DAVID
Entity type:Individual
Prefix:MR
First Name:JULIAN
Middle Name:DAVID
Last Name:LAWRENCE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2326 34TH ST
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95817-1212
Mailing Address - Country:US
Mailing Address - Phone:916-456-7973
Mailing Address - Fax:
Practice Address - Street 1:3353 BRADSHAW RD
Practice Address - Street 2:SUITE 103
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95827-2607
Practice Address - Country:US
Practice Address - Phone:916-857-1570
Practice Address - Fax:916-857-1580
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor