Provider Demographics
NPI:1144387143
Name:FRASER, JULIE MICHELE (RD)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:MICHELE
Last Name:FRASER
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10258 N FOWLER AVE
Mailing Address - Street 2:
Mailing Address - City:CLOVIS
Mailing Address - State:CA
Mailing Address - Zip Code:93619-9530
Mailing Address - Country:US
Mailing Address - Phone:559-779-0479
Mailing Address - Fax:559-448-5460
Practice Address - Street 1:7300 N FRESNO ST
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-2941
Practice Address - Country:US
Practice Address - Phone:559-448-2304
Practice Address - Fax:559-448-5460
Is Sole Proprietor?:No
Enumeration Date:2007-01-02
Last Update Date:2021-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
133V00000X
CA717742133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered