Provider Demographics
NPI:1588540140
Name:CHRISTENSEN, JULIA LARAE (PHN, RN)
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:LARAE
Last Name:CHRISTENSEN
Suffix:
Gender:F
Credentials:PHN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4701 STODDARD RD
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95356-9818
Mailing Address - Country:US
Mailing Address - Phone:209-652-3053
Mailing Address - Fax:
Practice Address - Street 1:917 OAKDALE RD
Practice Address - Street 2:
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95355-4593
Practice Address - Country:US
Practice Address - Phone:209-558-7400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-11
Last Update Date:2025-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95152356163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice