Provider Demographics
NPI:1720553605
Name:AUBE, JULIA (OT)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:
Last Name:AUBE
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 COMMERCIAL BLVD STE 5
Mailing Address - Street 2:
Mailing Address - City:NOVATO
Mailing Address - State:CA
Mailing Address - Zip Code:94949-6100
Mailing Address - Country:US
Mailing Address - Phone:415-884-9101
Mailing Address - Fax:415-952-9571
Practice Address - Street 1:6 COMMERCIAL BLVD STE 5
Practice Address - Street 2:
Practice Address - City:NOVATO
Practice Address - State:CA
Practice Address - Zip Code:94949-6100
Practice Address - Country:US
Practice Address - Phone:415-884-9101
Practice Address - Fax:415-952-9571
Is Sole Proprietor?:No
Enumeration Date:2018-10-08
Last Update Date:2018-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOT15947225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAOT15947OtherAOTA