Organization
JULIE KIRKES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JULIE TRACY LCSW (OWNER)
(575) 642-0984
Entity
Organization
Contact information
Practice address
5342 DUDLEY BLVD., MCCL/116, MCCLELLAN, CA 95652
(916) 561-7627
Mailing address
PO BOX 2344, NORTH HIGHLANDS, CA 95660-8344
(575) 642-0984
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
C-07799
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
15204278
—
NM
Enumeration date
05/12/2015
Last updated
01/18/2019
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