Provider Demographics
NPI:1396529244
Name:WHITEHEAD, JULIA KATHRYN DENBOER (PT DPT)
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:KATHRYN DENBOER
Last Name:WHITEHEAD
Suffix:
Gender:F
Credentials:PT DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:457 N ELM ST
Mailing Address - Street 2:
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92025-3001
Mailing Address - Country:US
Mailing Address - Phone:760-489-1969
Mailing Address - Fax:
Practice Address - Street 1:457 N ELM ST
Practice Address - Street 2:
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92025-3001
Practice Address - Country:US
Practice Address - Phone:760-489-1969
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-22
Last Update Date:2023-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA304626225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist