Provider Demographics
NPI:1760613046
Name:ARELLANO, JULIE ANN (MD)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:ANN
Last Name:ARELLANO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:5650 WHITELOCK PKWY STE 130
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95757-5927
Mailing Address - Country:US
Mailing Address - Phone:248-952-7564
Mailing Address - Fax:916-581-8794
Practice Address - Street 1:5650 WHITELOCK PKWY STE 103
Practice Address - Street 2:
Practice Address - City:ELK GROVE
Practice Address - State:CA
Practice Address - Zip Code:95757-5922
Practice Address - Country:US
Practice Address - Phone:916-957-8771
Practice Address - Fax:916-581-8794
Is Sole Proprietor?:No
Enumeration Date:2009-08-04
Last Update Date:2022-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1708712084B0040X
NY3080052084B0040X
MI43010946772084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084B0040XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyBehavioral Neurology & Neuropsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MID16083188Medicare PIN