Provider Demographics
NPI:1366033037
Name:URCIS, JULIA (LAC)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:
Last Name:URCIS
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11262 MOONEY FLAT RD
Mailing Address - Street 2:
Mailing Address - City:SMARTSVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95977-9522
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:101 PROVIDENCE MINE RD STE 103B
Practice Address - Street 2:
Practice Address - City:NEVADA CITY
Practice Address - State:CA
Practice Address - Zip Code:95959-2937
Practice Address - Country:US
Practice Address - Phone:530-362-8743
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-26
Last Update Date:2021-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA18932171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist