Provider Demographics
NPI:1215113741
Name:MIDDLETON, JULIA RAE (PA-C)
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:RAE
Last Name:MIDDLETON
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24035 NEWHALL RANCH RD
Mailing Address - Street 2:
Mailing Address - City:VALENCIA
Mailing Address - State:CA
Mailing Address - Zip Code:91355-5702
Mailing Address - Country:US
Mailing Address - Phone:661-291-3444
Mailing Address - Fax:661-291-3456
Practice Address - Street 1:24035 NEWHALL RANCH RD
Practice Address - Street 2:
Practice Address - City:VALENCIA
Practice Address - State:CA
Practice Address - Zip Code:91355-5702
Practice Address - Country:US
Practice Address - Phone:661-291-3444
Practice Address - Fax:661-291-3456
Is Sole Proprietor?:No
Enumeration Date:2008-01-15
Last Update Date:2013-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDPA737363A00000X
CAPA22232363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant