Provider Demographics
NPI:1275109639
Name:HANNA, JULIANNA MARIE (PA)
Entity Type:Individual
Prefix:
First Name:JULIANNA
Middle Name:MARIE
Last Name:HANNA
Suffix:
Gender:F
Credentials:PA
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Mailing Address - Street 1:2920 TELEGRAPH AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94705-2031
Mailing Address - Country:US
Mailing Address - Phone:844-234-7741
Mailing Address - Fax:
Practice Address - Street 1:3032 WILSHIRE BLVD STE A
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90403-2370
Practice Address - Country:US
Practice Address - Phone:310-971-9957
Practice Address - Fax:888-972-1912
Is Sole Proprietor?:No
Enumeration Date:2021-05-27
Last Update Date:2024-01-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA63371363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant