Provider Demographics
NPI:1912538166
Name:OATES, JULIE ANN (CNM)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:ANN
Last Name:OATES
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:ANN
Other - Last Name:SORENSEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:2015 MARSHALLFIELD LN UNIT B
Mailing Address - Street 2:
Mailing Address - City:REDONDO BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90278-4213
Mailing Address - Country:US
Mailing Address - Phone:480-326-9753
Mailing Address - Fax:
Practice Address - Street 1:2015 MARSHALLFIELD LN UNIT B
Practice Address - Street 2:
Practice Address - City:REDONDO BEACH
Practice Address - State:CA
Practice Address - Zip Code:90278-4213
Practice Address - Country:US
Practice Address - Phone:480-326-9753
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-27
Last Update Date:2020-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA236051367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife