Healthcare Provider Details

I. General information

NPI: 1962587709
Provider Name (Legal Business Name): JULIE HURD O.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/26/2006
Last Update Date: 11/30/2021
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1821 E DAILY DR
CAMARILLO CA
93010-6201
US

IV. Provider business mailing address

365 E HILLCREST DR
THOUSAND OAKS CA
91360-5820
US

V. Phone/Fax

Practice location:
  • Phone: 805-987-5300
  • Fax: 805-987-5330
Mailing address:
  • Phone: 805-987-5300
  • Fax: 805-987-5330

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number12037
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: