MEDICARE: JULIE WELLS M.S.

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
1	106H00000X	Marriage & Family Therapist	79760	CA

General Provider Information

NPI Number	:	1982014627
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIE WELLS M.S.

Provider Business Mailing Address
First Line	:	1521 N LAKE PLACID AVE
Second Line	:
City	:	EAGLE
State	:	ID
Zip	:	83616-5960
Country	:	US
Telephone Number	:	949-391-3505
Fax Number	:

Provider Business Practice Location Address
First Line	:	1521 N LAKE PLACID AVE
Second Line	:
City	:	EAGLE
State	:	ID
Zip	:	83616-5960
Country	:	US
Telephone Number	:	949-391-3505
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/03/2014
Last Update Date	:	12/22/2025

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Directions to “ JULIE WELLS M.S.” Practice Location

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