Provider Demographics
NPI:1720217433
Name:RHODE, JULIANNA D (PA)
Entity Type:Individual
Prefix:
First Name:JULIANNA
Middle Name:D
Last Name:RHODE
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:3355 MICHELSON DR STE 490
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92612-0685
Mailing Address - Country:US
Mailing Address - Phone:949-526-8375
Mailing Address - Fax:949-526-8385
Practice Address - Street 1:3355 MICHELSON DR STE 490
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92612-0685
Practice Address - Country:US
Practice Address - Phone:949-526-8375
Practice Address - Fax:949-526-8385
Is Sole Proprietor?:No
Enumeration Date:2009-07-02
Last Update Date:2021-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA 20309363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant