Provider Demographics
NPI:1154721223
Name:YI, JULIA J (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:J
Last Name:YI
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17215 STUDEBAKER RD.
Mailing Address - Street 2:#180
Mailing Address - City:CERRITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90703
Mailing Address - Country:US
Mailing Address - Phone:562-704-6791
Mailing Address - Fax:562-704-6783
Practice Address - Street 1:17215 STUDEBAKER RD.
Practice Address - Street 2:#180
Practice Address - City:CERRITOS
Practice Address - State:CA
Practice Address - Zip Code:90703
Practice Address - Country:US
Practice Address - Phone:562-704-6791
Practice Address - Fax:562-704-6783
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-26
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASP 21934235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist