1235456419 NPI number — JULIE EVANS DBA ADVANCED OCCUPATIONAL THERAPY

Table of content: (NPI 1235456419)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1235456419 NPI number — JULIE EVANS DBA ADVANCED OCCUPATIONAL THERAPY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
JULIE EVANS DBA ADVANCED OCCUPATIONAL THERAPY
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1235456419
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/13/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7108 N FRESNO ST
Provider Second Line Business Mailing Address:
SUITE 380
Provider Business Mailing Address City Name:
FRESNO
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
93720-2938
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
559-903-2386
Provider Business Mailing Address Fax Number:
559-451-0564

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7108 N FRESNO ST
Provider Second Line Business Practice Location Address:
SUITE 380
Provider Business Practice Location Address City Name:
FRESNO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93720-2938
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
559-903-2386
Provider Business Practice Location Address Fax Number:
559-451-0564
Provider Enumeration Date:
04/27/2010

Additional Information

Authorized Official

Authorized Official Last Name:
EVANS
Authorized Official First Name:
JULIE
Authorized Official Middle Name:
ANN
Authorized Official Title or Position:
OCCUPATIONAL THERAPIS
Authorized Official Telephone Number:
559-903-2386

Provider Taxonomy Codes

  • Taxonomy code: 225XH1200X , with the licence number:  OT8087 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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