Healthcare Provider Details

I. General information

NPI: 1447829106
Provider Name (Legal Business Name): JULIA DIXON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2021
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1700 E WILSHIRE AVE
FULLERTON CA
92831-4115
US

IV. Provider business mailing address

3530 E LA PALMA AVE APT 359
ANAHEIM CA
92806-2163
US

V. Phone/Fax

Practice location:
  • Phone: 714-447-7765
  • Fax:
Mailing address:
  • Phone: 714-366-4320
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number1447829106
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: