Provider Demographics
NPI:1992038582
Name:AUCREMAN, JULIET RICHARDSON (OTR)
Entity Type:Individual
Prefix:
First Name:JULIET
Middle Name:RICHARDSON
Last Name:AUCREMAN
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 LA PLACENTIA
Mailing Address - Street 2:
Mailing Address - City:SAN CLEMENTE
Mailing Address - State:CA
Mailing Address - Zip Code:92672-3817
Mailing Address - Country:US
Mailing Address - Phone:949-388-9859
Mailing Address - Fax:
Practice Address - Street 1:107 LA PLACENTIA
Practice Address - Street 2:
Practice Address - City:SAN CLEMENTE
Practice Address - State:CA
Practice Address - Zip Code:92672-3817
Practice Address - Country:US
Practice Address - Phone:949-388-9859
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-14
Last Update Date:2009-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOT10457225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist