Provider Demographics
NPI:1619249539
Name:BARKER, JULIE ANN MI CHA (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:JULIE ANN
Middle Name:MI CHA
Last Name:BARKER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:JULIE ANN
Other - Middle Name:MI CHA
Other - Last Name:BARKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6606 MAPLESHADE LN APT 21B
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75252-8559
Mailing Address - Country:US
Mailing Address - Phone:254-760-7765
Mailing Address - Fax:
Practice Address - Street 1:1411 E 31ST ST DEPT OF
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94602-1092
Practice Address - Country:US
Practice Address - Phone:510-437-4800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-08
Last Update Date:2023-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPA.0007794363A00000X
TXPA09150363A00000X
363AM0700X
CAPA55138363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH1102983OtherNCCPA IDENTIFICATION NUMBER