Provider Demographics
NPI:1932659737
Name:PERALES, JULIE ELAINE (DPT)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:ELAINE
Last Name:PERALES
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:ELAINE
Other - Last Name:SIMONIAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1132 LELAND AVE
Mailing Address - Street 2:
Mailing Address - City:TULARE
Mailing Address - State:CA
Mailing Address - Zip Code:93274-7811
Mailing Address - Country:US
Mailing Address - Phone:559-684-0611
Mailing Address - Fax:559-684-0612
Practice Address - Street 1:1132 LELAND AVE
Practice Address - Street 2:
Practice Address - City:TULARE
Practice Address - State:CA
Practice Address - Zip Code:93274-7811
Practice Address - Country:US
Practice Address - Phone:559-684-0611
Practice Address - Fax:559-684-0612
Is Sole Proprietor?:No
Enumeration Date:2016-10-05
Last Update Date:2021-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT291763225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist