Provider Demographics
NPI:1588469662
Name:PACKHAM, JULIA (PT, DPT)
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:
Last Name:PACKHAM
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:744 POLI ST APT A
Mailing Address - Street 2:
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93001-2980
Mailing Address - Country:US
Mailing Address - Phone:805-910-6035
Mailing Address - Fax:
Practice Address - Street 1:1011 RANCHO CONEJO BLVD
Practice Address - Street 2:
Practice Address - City:NEWBURY PARK
Practice Address - State:CA
Practice Address - Zip Code:91320-1718
Practice Address - Country:US
Practice Address - Phone:844-518-7246
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-13
Last Update Date:2025-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy