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NPI Code Detail

MEDICARE: MICHELLE DIZON JULATON PNP

MEDICARE:   MICHELLE DIZON JULATON  PNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered Nurse757436CA
2363LP0200XPediatric Nurse Practitioner23382CA

General Provider Information

NPI Number : 1417381575
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHELLE DIZON JULATON PNP
Provider Business Mailing Address
First Line : 340 EUREKA SQ
Second Line :
City : PACIFICA
State : CA
Zip : 94044-2652
Country : US
Telephone Number : 650-359-1675
Fax Number :
Provider Business Practice Location Address
First Line : 340 EUREKA SQ
Second Line :
City : PACIFICA
State : CA
Zip : 94044-2652
Country : US
Telephone Number : 650-359-1675
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/26/2013
Last Update Date : 08/26/2013

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Directions to “ MICHELLE DIZON JULATON PNP” Practice Location

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