Provider Demographics
NPI:1407461908
Name:LEFMANN, JULIE
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:LEFMANN
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 1:1445 38TH AVE # B
Mailing Address - Street 2:
Mailing Address - City:SANTA CRUZ
Mailing Address - State:CA
Mailing Address - Zip Code:95062-3200
Mailing Address - Country:US
Mailing Address - Phone:408-529-8031
Mailing Address - Fax:
Practice Address - Street 1:15951 LOS GATOS BLVD STE 18
Practice Address - Street 2:
Practice Address - City:LOS GATOS
Practice Address - State:CA
Practice Address - Zip Code:95032-3488
Practice Address - Country:US
Practice Address - Phone:408-529-8031
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-11
Last Update Date:2020-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA18946225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist