Healthcare Provider Details

I. General information

NPI: 1144174541
Provider Name (Legal Business Name): JS PODIATRY & WOUND CARE, PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/23/2026
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 H ST # 2050
CHULA VISTA CA
91910-5555
US

IV. Provider business mailing address

333 H ST # 2050
CHULA VISTA CA
91910-5555
US

V. Phone/Fax

Practice location:
  • Phone: 310-625-7188
  • Fax: 619-860-0797
Mailing address:
  • Phone: 310-625-7188
  • Fax: 619-860-0797

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number
License Number State

VIII. Authorized Official

Name: DR. JULIA V SOUVOROVA
Title or Position: OWNER
Credential: DPM
Phone: 310-625-7188