Theriault, Julie A

Theriault, Julie A is an individual health care provider with primary practice located at 8170 Laguna Blvd #215, Elk Grove CA 95758-7901. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Theriault, Julie A can be contacted via phone (916) 691-5900.

Contact Information

Primary practice address
8170 Laguna Blvd #215 Elk Grove CA 95758-7901
Phone: (916) 691-5900
Fax: (916) 691-6747
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA12102 California

Profile Details

NPI number 1952492936
LBN Legal business name Theriault, Julie A
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 27th, 2006
Last updated Jul 27th, 2015 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1952492936 NPPES
California MEDICAID 0PA121020

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