Provider Demographics
NPI:1295205557
Name:OLA, JULIE ERATH (FNP-C)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:ERATH
Last Name:OLA
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:FAY
Other - Last Name:ERATH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3800 KILROY AIRPORT WAY STE 270
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90806-2497
Mailing Address - Country:US
Mailing Address - Phone:800-964-4364
Mailing Address - Fax:
Practice Address - Street 1:3800 KILROY AIRPORT WAY STE 270
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90806-2497
Practice Address - Country:US
Practice Address - Phone:800-964-4364
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-29
Last Update Date:2023-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95180430163W00000X
CA95025994363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse