Provider Demographics
NPI:1558185330
Name:JOHNSON, JULIE CLAIRE (MED)
Entity type:Individual
Prefix:MS
First Name:JULIE
Middle Name:CLAIRE
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2339 JEFFERSON AVE
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94703-1619
Mailing Address - Country:US
Mailing Address - Phone:510-292-0929
Mailing Address - Fax:
Practice Address - Street 1:2339 JEFFERSON AVE
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94703-1619
Practice Address - Country:US
Practice Address - Phone:510-292-0929
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-08
Last Update Date:2024-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach