Provider Demographics
NPI:1225238801
Name:LAUX, JULIE PENDLETON (SP)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:PENDLETON
Last Name:LAUX
Suffix:
Gender:F
Credentials:SP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13746 BASSMORE DR
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92129-3220
Mailing Address - Country:US
Mailing Address - Phone:858-349-6744
Mailing Address - Fax:
Practice Address - Street 1:5576 DEHESA RD
Practice Address - Street 2:
Practice Address - City:EL CAJON
Practice Address - State:CA
Practice Address - Zip Code:92019-1616
Practice Address - Country:US
Practice Address - Phone:619-445-9118
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-20
Last Update Date:2010-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12104554235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist