Provider Demographics
NPI:1235482159
Name:BERESFORD, JULIA LINDESY (MA, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:JULIA
Middle Name:LINDESY
Last Name:BERESFORD
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5296 NORCRIS LN
Mailing Address - Street 2:
Mailing Address - City:YORBA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92886-4111
Mailing Address - Country:US
Mailing Address - Phone:714-944-0454
Mailing Address - Fax:
Practice Address - Street 1:5296 NORCRIS LANE
Practice Address - Street 2:
Practice Address - City:YORBA LINDA
Practice Address - State:CA
Practice Address - Zip Code:92886-4111
Practice Address - Country:US
Practice Address - Phone:714-944-0454
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-16
Last Update Date:2012-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA9847235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist