Provider Demographics
NPI:1437353257
Name:JULIAN, TINA (LVN)
Entity Type:Individual
Prefix:
First Name:TINA
Middle Name:
Last Name:JULIAN
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4974 EL CAJON BLVD
Mailing Address - Street 2:SUITE A
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92115-4677
Mailing Address - Country:US
Mailing Address - Phone:619-286-4600
Mailing Address - Fax:
Practice Address - Street 1:4974 EL CAJON BLVD
Practice Address - Street 2:SUITE A
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92115-4677
Practice Address - Country:US
Practice Address - Phone:619-286-4600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAVN 216640164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse