Provider Demographics
NPI:1649245051
Name:KRILL, JULIANNA ELAINE (DPT)
Entity Type:Individual
Prefix:MISS
First Name:JULIANNA
Middle Name:ELAINE
Last Name:KRILL
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:MRS
Other - First Name:JULIANNA
Other - Middle Name:ELAINE
Other - Last Name:CLEMENTS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:1535 WILD OAK LN
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:CA
Mailing Address - Zip Code:95648-8236
Mailing Address - Country:US
Mailing Address - Phone:916-543-8443
Mailing Address - Fax:
Practice Address - Street 1:6600 MERCY CT
Practice Address - Street 2:SUITE 180
Practice Address - City:FAIR OAKS
Practice Address - State:CA
Practice Address - Zip Code:95628-3158
Practice Address - Country:US
Practice Address - Phone:916-962-3662
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-20
Last Update Date:2021-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA30082225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist