Provider Demographics
NPI:1700855525
Name:MOONEY, JULIA E (MD)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:E
Last Name:MOONEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2036 RAILROAD AVE
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96001-1801
Mailing Address - Country:US
Mailing Address - Phone:530-255-1000
Mailing Address - Fax:530-241-1335
Practice Address - Street 1:2036 RAILROAD AVE
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96001-1801
Practice Address - Country:US
Practice Address - Phone:530-255-1000
Practice Address - Fax:530-255-1056
Is Sole Proprietor?:No
Enumeration Date:2006-03-15
Last Update Date:2023-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA54429207ZC0500X, 207ZP0101X, 207ZP0102X
OR10257207ZC0500X, 207ZP0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
No207ZC0500XAllopathic & Osteopathic PhysiciansPathologyCytopathology
No207ZP0101XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
G12182Medicare UPIN