Healthcare Provider Details

I. General information

NPI: 1467769984
Provider Name (Legal Business Name): JULIE ANN DAWSON OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/03/2010
Last Update Date: 09/07/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16269 LAGUNA CANYON RD
IRVINE CA
92618-3603
US

IV. Provider business mailing address

4835 E ANAHEIM ST #107
LONG BEACH CA
90804-3254
US

V. Phone/Fax

Practice location:
  • Phone: 949-788-9236
  • Fax: 949-788-9246
Mailing address:
  • Phone: 562-597-4886
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License NumberOT8005
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: