Provider Demographics
NPI:1891223731
Name:JOHNSON, JULIANNA MARIE (OTR/L)
Entity Type:Individual
Prefix:
First Name:JULIANNA
Middle Name:MARIE
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:JULIANNA
Other - Middle Name:MARIE
Other - Last Name:COOPER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:28765 SINGLE OAK DR STE 125
Mailing Address - Street 2:
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92590-3678
Mailing Address - Country:US
Mailing Address - Phone:951-552-1126
Mailing Address - Fax:
Practice Address - Street 1:28765 SINGLE OAK DR STE 125
Practice Address - Street 2:
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92590-3678
Practice Address - Country:US
Practice Address - Phone:951-552-1126
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-23
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOT16317225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist