Provider Demographics
NPI:1295566123
Name:MOZINGO, JULIE TRUE (LMT,LNMT)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:TRUE
Last Name:MOZINGO
Suffix:
Gender:F
Credentials:LMT,LNMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:360 RUNDGREN WAY
Mailing Address - Street 2:
Mailing Address - City:FOLSOM
Mailing Address - State:CA
Mailing Address - Zip Code:95630-8426
Mailing Address - Country:US
Mailing Address - Phone:650-483-2485
Mailing Address - Fax:
Practice Address - Street 1:540 PLAZA DR STE 110
Practice Address - Street 2:
Practice Address - City:FOLSOM
Practice Address - State:CA
Practice Address - Zip Code:95630-4785
Practice Address - Country:US
Practice Address - Phone:650-483-2485
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-12
Last Update Date:2024-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA4625174H00000X, 225400000X, 173C00000X, 225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No174H00000XOther Service ProvidersHealth Educator
No225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner
No173C00000XOther Service ProvidersReflexologist