Provider Demographics
NPI:1407131857
Name:BOYER, JULIA ANNE
Entity Type:Individual
Prefix:MRS
First Name:JULIA
Middle Name:ANNE
Last Name:BOYER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JULIA
Other - Middle Name:ANNE
Other - Last Name:SEAMARK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C, MS ATC
Mailing Address - Street 1:280 S MAIN ST STE 200
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92868-3852
Mailing Address - Country:US
Mailing Address - Phone:714-634-4567
Mailing Address - Fax:714-634-4569
Practice Address - Street 1:280 S MAIN ST STE 200
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-3852
Practice Address - Country:US
Practice Address - Phone:714-634-4567
Practice Address - Fax:714-634-4569
Is Sole Proprietor?:No
Enumeration Date:2011-10-18
Last Update Date:2012-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA21882363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant