Provider Demographics
NPI:1255704896
Name:NIELSEN, JULIE ANN (HAD)
Entity type:Individual
Prefix:MS
First Name:JULIE
Middle Name:ANN
Last Name:NIELSEN
Suffix:
Gender:F
Credentials:HAD
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:ANN
Other - Last Name:NIELSEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:HEARINGAIDDISPENSER
Mailing Address - Street 1:13900 MARQUESAS WAY APT 3115
Mailing Address - Street 2:
Mailing Address - City:MARINA DEL REY
Mailing Address - State:CA
Mailing Address - Zip Code:90292-6024
Mailing Address - Country:US
Mailing Address - Phone:773-251-9218
Mailing Address - Fax:
Practice Address - Street 1:3701 SKYPARK DR
Practice Address - Street 2:150
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-4753
Practice Address - Country:US
Practice Address - Phone:310-802-7933
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-04
Last Update Date:2015-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAHA8006237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist