Provider Demographics
NPI:1285665620
Name:GEBHARDT, JULIE MARIE (PA)
Entity Type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:MARIE
Last Name:GEBHARDT
Suffix:
Gender:F
Credentials:PA
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Mailing Address - Street 1:2276 SUMMER DR
Mailing Address - Street 2:
Mailing Address - City:EL DORADO HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:95762-6315
Mailing Address - Country:US
Mailing Address - Phone:916-467-2662
Mailing Address - Fax:
Practice Address - Street 1:3001 DOUGLAS BLVD STE 325
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95661-4289
Practice Address - Country:US
Practice Address - Phone:916-241-9844
Practice Address - Fax:916-241-9845
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2015-06-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA16078363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical