Provider Demographics
NPI:1982987749
Name:FITZGERALD, JULIE ELDREDGE (PA-C)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:ELDREDGE
Last Name:FITZGERALD
Suffix:
Gender:
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 1:1035 PLACER ST
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96001-1170
Mailing Address - Country:US
Mailing Address - Phone:530-246-5710
Mailing Address - Fax:530-245-0638
Practice Address - Street 1:1035 PLACER ST
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96001-1170
Practice Address - Country:US
Practice Address - Phone:530-246-5710
Practice Address - Fax:530-245-0638
Is Sole Proprietor?:No
Enumeration Date:2011-09-27
Last Update Date:2025-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA64377363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM69756279Medicaid
NMNMAA2057Medicare Oscar/Certification