Provider Demographics
NPI:1831481100
Name:GONZALES, JULIE LYNN (PT)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:LYNN
Last Name:GONZALES
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:LYNN
Other - Last Name:HAMALAINEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:21628 GOLDEN STAR BLVD
Mailing Address - Street 2:
Mailing Address - City:TEHACHAPI
Mailing Address - State:CA
Mailing Address - Zip Code:93561-8902
Mailing Address - Country:US
Mailing Address - Phone:661-823-8101
Mailing Address - Fax:
Practice Address - Street 1:21628 GOLDEN STAR BLVD
Practice Address - Street 2:
Practice Address - City:TEHACHAPI
Practice Address - State:CA
Practice Address - Zip Code:93561-8902
Practice Address - Country:US
Practice Address - Phone:661-823-8101
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-05
Last Update Date:2011-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT 18941225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist