Provider Demographics
NPI:1083307912
Name:SAMAY, JULIE (CCP)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:SAMAY
Suffix:
Gender:F
Credentials:CCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1161 VIA ARROYO
Mailing Address - Street 2:
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93003-1326
Mailing Address - Country:US
Mailing Address - Phone:360-481-8981
Mailing Address - Fax:
Practice Address - Street 1:1161 VIA ARROYO
Practice Address - Street 2:
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-1326
Practice Address - Country:US
Practice Address - Phone:360-481-8981
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-26
Last Update Date:2023-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA040057242T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes242T00000XTechnologists, Technicians & Other Technical Service ProvidersPerfusionist