Provider Demographics
NPI:1164592408
Name:BAIL, JULIA K (RNP)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:K
Last Name:BAIL
Suffix:
Gender:F
Credentials:RNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27330 BANUELO AVE
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARITA
Mailing Address - State:CA
Mailing Address - Zip Code:91350-2118
Mailing Address - Country:US
Mailing Address - Phone:661-263-6817
Mailing Address - Fax:805-241-1163
Practice Address - Street 1:200 MED PLZ
Practice Address - Street 2:SUITE 420
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90095-0001
Practice Address - Country:US
Practice Address - Phone:310-206-6232
Practice Address - Fax:805-241-1163
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2023-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA561772207RG0300X
CA14399363LP0808X, 363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CARN561772Medicaid
CAQ75366Medicare UPIN
CARN561772Medicaid