Provider Demographics
NPI:1639193055
Name:BERGMANN, JULIE A (PT, DPT, OCS)
Entity Type:Individual
Prefix:MS
First Name:JULIE
Middle Name:A
Last Name:BERGMANN
Suffix:
Gender:F
Credentials:PT, DPT, OCS
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:A
Other - Last Name:SCHAPKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:16271 BEACH BLVD
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92647-4102
Mailing Address - Country:US
Mailing Address - Phone:714-375-1755
Mailing Address - Fax:714-375-1757
Practice Address - Street 1:16271 BEACH BLVD
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92647-4102
Practice Address - Country:US
Practice Address - Phone:714-375-1755
Practice Address - Fax:714-375-1757
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2020-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT162792251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPT16279Medicare ID - Type UnspecifiedMEDICARE