Provider Demographics
NPI:1124829601
Name:VELASQUEZ, JULIE
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:VELASQUEZ
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18060 GRACE LN UNIT 101
Mailing Address - Street 2:
Mailing Address - City:CANYON COUNTRY
Mailing Address - State:CA
Mailing Address - Zip Code:91387-6495
Mailing Address - Country:US
Mailing Address - Phone:661-936-1446
Mailing Address - Fax:
Practice Address - Street 1:919 1ST ST
Practice Address - Street 2:
Practice Address - City:SAN FERNANDO
Practice Address - State:CA
Practice Address - Zip Code:91340-2957
Practice Address - Country:US
Practice Address - Phone:818-256-1124
Practice Address - Fax:818-698-0311
Is Sole Proprietor?:No
Enumeration Date:2025-03-21
Last Update Date:2025-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes373H00000XNursing Service Related ProvidersDay Training/Habilitation Specialist
No172V00000XOther Service ProvidersCommunity Health Worker