Provider Demographics
NPI:1972045847
Name:MOHR, JULIE D (MED, IBCLC)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:D
Last Name:MOHR
Suffix:
Gender:F
Credentials:MED, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8460 EVERGLADE DR
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95826-3615
Mailing Address - Country:US
Mailing Address - Phone:530-318-1097
Mailing Address - Fax:
Practice Address - Street 1:8460 EVERGLADE DR
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95826-3615
Practice Address - Country:US
Practice Address - Phone:530-318-1097
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-09
Last Update Date:2016-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN