Provider Demographics
NPI:1205211109
Name:SALVADOR, JULIA TATTAN (PT, DPT)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:TATTAN
Last Name:SALVADOR
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:JULIA
Other - Middle Name:K
Other - Last Name:TATTAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1108 WALTZ CT
Mailing Address - Street 2:
Mailing Address - City:VALLEJO
Mailing Address - State:CA
Mailing Address - Zip Code:94591-8054
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1108 WALTZ CT
Practice Address - Street 2:
Practice Address - City:VALLEJO
Practice Address - State:CA
Practice Address - Zip Code:94591-8054
Practice Address - Country:US
Practice Address - Phone:616-886-8380
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-22
Last Update Date:2022-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA42644225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist