Healthcare Provider Details

I. General information

NPI: 1962642371
Provider Name (Legal Business Name): JULIE PRENTICE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/25/2009
Last Update Date: 02/25/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5251 OFFICE PARK DRIVE SUITE 301
BAKERSFIELD CA
93309
US

IV. Provider business mailing address

10570 SE WASHINGTON ST SUITE 202
PORTLAND OR
97216
US

V. Phone/Fax

Practice location:
  • Phone: 661-859-1186
  • Fax: 661-859-1568
Mailing address:
  • Phone: 503-257-6800
  • Fax: 503-257-6810

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: