Provider Demographics
NPI:1669809596
Name:VAUGHAN, JULIA T (RDHAP)
Entity type:Individual
Prefix:MS
First Name:JULIA
Middle Name:T
Last Name:VAUGHAN
Suffix:
Gender:F
Credentials:RDHAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6077 COFFEE RD # 4-61
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93308-9416
Mailing Address - Country:US
Mailing Address - Phone:661-589-8225
Mailing Address - Fax:661-589-8225
Practice Address - Street 1:6077 COFFEE RD # 4-61
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93308-9416
Practice Address - Country:US
Practice Address - Phone:661-589-8225
Practice Address - Fax:661-589-8225
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-10
Last Update Date:2014-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARDHAP 474124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist