Healthcare Provider Details

I. General information

NPI: 1649393067
Provider Name (Legal Business Name): JULIA NICOLE SEIKER LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/09/2007
Last Update Date: 02/06/2024
Certification Date: 02/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23950 PRADO LN
COLTON CA
92324-9734
US

IV. Provider business mailing address

10630 TOWN CENTER DR SUITE 111
RANCHO CUCAMONGA CA
91730-6805
US

V. Phone/Fax

Practice location:
  • Phone: 909-514-1958
  • Fax:
Mailing address:
  • Phone: 909-689-6127
  • Fax: 909-912-8272

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number28968
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: