Provider Demographics
NPI:1700541950
Name:BIKUL, JAVEIT TRAVIS
Entity type:Individual
Prefix:
First Name:JAVEIT
Middle Name:TRAVIS
Last Name:BIKUL
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 1:952 SCHOOL ST # 180
Mailing Address - Street 2:
Mailing Address - City:NAPA
Mailing Address - State:CA
Mailing Address - Zip Code:94559-2826
Mailing Address - Country:US
Mailing Address - Phone:707-690-0321
Mailing Address - Fax:
Practice Address - Street 1:34 QUEENS CT
Practice Address - Street 2:
Practice Address - City:NAPA
Practice Address - State:CA
Practice Address - Zip Code:94558-4458
Practice Address - Country:US
Practice Address - Phone:707-690-0321
Practice Address - Fax:877-657-9456
Is Sole Proprietor?:No
Enumeration Date:2021-11-02
Last Update Date:2021-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1020111041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical