Provider Demographics
NPI:1780211219
Name:SCHLICHTING-BADER, JULIANNE ELIZABETH (PA-C, PHARMD)
Entity type:Individual
Prefix:
First Name:JULIANNE
Middle Name:ELIZABETH
Last Name:SCHLICHTING-BADER
Suffix:
Gender:F
Credentials:PA-C, PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4900 AIRPORT PLAZA DR STE 200
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90815-1375
Mailing Address - Country:US
Mailing Address - Phone:562-490-9900
Mailing Address - Fax:562-452-7078
Practice Address - Street 1:2067 W VISTA WAY STE 250
Practice Address - Street 2:
Practice Address - City:VISTA
Practice Address - State:CA
Practice Address - Zip Code:92083-6034
Practice Address - Country:US
Practice Address - Phone:562-490-9900
Practice Address - Fax:562-452-7078
Is Sole Proprietor?:No
Enumeration Date:2020-03-25
Last Update Date:2025-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA65292363A00000X
MN1238971835P0200X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No1835P0200XPharmacy Service ProvidersPharmacistPediatrics