Provider Demographics
NPI:1548598394
Name:LETTS, JULIA ANE (MA, OTR)
Entity Type:Individual
Prefix:MS
First Name:JULIA
Middle Name:ANE
Last Name:LETTS
Suffix:
Gender:F
Credentials:MA, OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7100 TUNNEY AVE
Mailing Address - Street 2:
Mailing Address - City:RESEDA
Mailing Address - State:CA
Mailing Address - Zip Code:91335-3751
Mailing Address - Country:US
Mailing Address - Phone:818-687-8875
Mailing Address - Fax:818-344-9045
Practice Address - Street 1:7100 TUNNEY AVE
Practice Address - Street 2:
Practice Address - City:RESEDA
Practice Address - State:CA
Practice Address - Zip Code:91335-3751
Practice Address - Country:US
Practice Address - Phone:818-687-8875
Practice Address - Fax:818-344-9045
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-04
Last Update Date:2009-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOT 5339225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAOT 0053390OtherBLUE SHIELD