Provider Demographics
NPI:1760522551
Name:HOLT, JULIE (DSC, MPT, CPC, ELIMP)
Entity Type:Individual
Prefix:DR
First Name:JULIE
Middle Name:
Last Name:HOLT
Suffix:
Gender:F
Credentials:DSC, MPT, CPC, ELIMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 CORPORATE PLAZA DR STE 120
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-7995
Mailing Address - Country:US
Mailing Address - Phone:949-266-7893
Mailing Address - Fax:
Practice Address - Street 1:17232 RED HILL AVE
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92614-5628
Practice Address - Country:US
Practice Address - Phone:949-462-0560
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-08
Last Update Date:2019-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT 242072251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic