Healthcare Provider Details

I. General information

NPI: 1326278045
Provider Name (Legal Business Name): MS. JULIA MICHELLE WINTERS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/15/2009
Last Update Date: 10/04/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11429 VALLEY BLVD
EL MONTE CA
91731-3229
US

IV. Provider business mailing address

11429 VALLEY BLVD
EL MONTE CA
91731-3229
US

V. Phone/Fax

Practice location:
  • Phone: 626-442-8391
  • Fax:
Mailing address:
  • Phone: 626-442-8391
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number73693
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number28568
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: