Provider Demographics
NPI:1134265895
Name:JULIUSSON, JULIA MARGUERITE (PHYSICAL THERAPIST)
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:MARGUERITE
Last Name:JULIUSSON
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:JULIA
Other - Middle Name:MARGUERITE
Other - Last Name:BOEGEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5 STONEBROOK
Mailing Address - Street 2:
Mailing Address - City:ALISO VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92656-1947
Mailing Address - Country:US
Mailing Address - Phone:949-305-3536
Mailing Address - Fax:
Practice Address - Street 1:5 STONEBROOK
Practice Address - Street 2:
Practice Address - City:ALISO VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92656-1947
Practice Address - Country:US
Practice Address - Phone:949-305-3536
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14776225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist