Provider Demographics
NPI:1033781687
Name:CORDERO, JULIE ANN (MSN,APRN,FNP-C)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:ANN
Last Name:CORDERO
Suffix:
Gender:F
Credentials:MSN,APRN,FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19675 GRIFFITH DR
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARITA
Mailing Address - State:CA
Mailing Address - Zip Code:91350-3699
Mailing Address - Country:US
Mailing Address - Phone:781-300-1613
Mailing Address - Fax:
Practice Address - Street 1:25775 MCBEAN PKWY STE 106
Practice Address - Street 2:
Practice Address - City:VALENCIA
Practice Address - State:CA
Practice Address - Zip Code:91355-3702
Practice Address - Country:US
Practice Address - Phone:661-362-8100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-13
Last Update Date:2021-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95016113363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily