Provider Demographics
NPI:1043557051
Name:SIMONTON, JULIA CATHERINE (LAC)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:CATHERINE
Last Name:SIMONTON
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:JULIA
Other - Middle Name:CATHERINE
Other - Last Name:FREEMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LAC
Mailing Address - Street 1:8950 VILLA LA JOLLA DR STE B129
Mailing Address - Street 2:
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92037-1731
Mailing Address - Country:US
Mailing Address - Phone:858-450-0620
Mailing Address - Fax:858-450-2175
Practice Address - Street 1:8950 VILLA LA JOLLA DR STE B129
Practice Address - Street 2:
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037-1731
Practice Address - Country:US
Practice Address - Phone:858-450-0620
Practice Address - Fax:858-450-2175
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-10
Last Update Date:2023-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC14152171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist