Healthcare Provider Details

I. General information

NPI: 1417556929
Provider Name (Legal Business Name): JULIA ZANE FOGLEMAN OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/26/2020
Last Update Date: 04/22/2026
Certification Date: 04/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

84 E J ST
CHULA VISTA CA
91910-6115
US

IV. Provider business mailing address

921 14TH ST
SAN DIEGO CA
92154-1804
US

V. Phone/Fax

Practice location:
  • Phone: 619-425-9600
  • Fax:
Mailing address:
  • Phone: 870-514-6955
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number24142
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number21595
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOTR3449
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: