Provider Demographics
NPI:1508536301
Name:HERBERT, JULIA-ANNE (PT, DPT)
Entity Type:Individual
Prefix:
First Name:JULIA-ANNE
Middle Name:
Last Name:HERBERT
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1246 SUNNY OAKS CIR
Mailing Address - Street 2:
Mailing Address - City:ALTADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91001-1543
Mailing Address - Country:US
Mailing Address - Phone:626-394-6281
Mailing Address - Fax:
Practice Address - Street 1:25115 MADISON AVE
Practice Address - Street 2:
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92562-8967
Practice Address - Country:US
Practice Address - Phone:951-600-9070
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-14
Last Update Date:2021-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA300555225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist