Healthcare Provider Details

I. General information

NPI: 1275662629
Provider Name (Legal Business Name): JULIE WALKER CORREIA M.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/03/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2690 PACIFIC AVE STE 220
LONG BEACH CA
90806-2659
US

IV. Provider business mailing address

5605 S CORNING AVE
LOS ANGELES CA
90056-1304
US

V. Phone/Fax

Practice location:
  • Phone: 310-487-1575
  • Fax: 310-645-7501
Mailing address:
  • Phone: 310-645-7505
  • Fax: 310-645-7501

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License NumberAU56
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number2745
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: