Provider Demographics
NPI:1386817815
Name:SHELINE, JULIE MARIE
Entity Type:Individual
Prefix:MS
First Name:JULIE
Middle Name:MARIE
Last Name:SHELINE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1029 N BROADWAY
Mailing Address - Street 2:
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92026-3043
Mailing Address - Country:US
Mailing Address - Phone:760-489-4126
Mailing Address - Fax:
Practice Address - Street 1:398 D ST
Practice Address - Street 2:
Practice Address - City:RAMONA
Practice Address - State:CA
Practice Address - Zip Code:92065-2463
Practice Address - Country:US
Practice Address - Phone:760-788-9724
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-04
Last Update Date:2008-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator