Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225400000X | Rehabilitation Practitioner |
NPI | 1053589416 |
---|---|
Provider Name | Erica Julian |
First Address | Long Beach, CA 90805-2175 |
Second Address | Long Beach, CA 90805-2175 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/02/2008 |
Last Update Date | 04/09/2019 |