Provider Demographics
NPI:1386395267
Name:DOLE, JULIANNA ELISE (OTR/L)
Entity type:Individual
Prefix:
First Name:JULIANNA
Middle Name:ELISE
Last Name:DOLE
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27657 RON RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARITA
Mailing Address - State:CA
Mailing Address - Zip Code:91350-4338
Mailing Address - Country:US
Mailing Address - Phone:661-361-3606
Mailing Address - Fax:
Practice Address - Street 1:24070 COPPER HILL DR
Practice Address - Street 2:
Practice Address - City:SANTA CLARITA
Practice Address - State:CA
Practice Address - Zip Code:91354-4402
Practice Address - Country:US
Practice Address - Phone:661-361-3606
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-12
Last Update Date:2022-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA23006225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist