Provider Demographics
NPI:1497355234
Name:CASE, JULIE (LMT)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:CASE
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 VIA PRESA
Mailing Address - Street 2:
Mailing Address - City:SAN CLEMENTE
Mailing Address - State:CA
Mailing Address - Zip Code:92672-9456
Mailing Address - Country:US
Mailing Address - Phone:949-230-8026
Mailing Address - Fax:
Practice Address - Street 1:205 VIA PRESA
Practice Address - Street 2:I DO NOT WORK FROM HOME- I AM A CONTRACTOR
Practice Address - City:SAN CLEMENTE
Practice Address - State:CA
Practice Address - Zip Code:92672
Practice Address - Country:US
Practice Address - Phone:949-230-8026
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-30
Last Update Date:2020-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA10346225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist