Healthcare Provider Details

I. General information

NPI: 1285238048
Provider Name (Legal Business Name): JULIA A TEJEDA FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/23/2020
Last Update Date: 09/26/2023
Certification Date: 01/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2450 SAINT JOSEPH AVE
LONG BEACH CA
90815-1833
US

IV. Provider business mailing address

400 W 30TH ST
LOS ANGELES CA
90007-3320
US

V. Phone/Fax

Practice location:
  • Phone: 562-225-3000
  • Fax:
Mailing address:
  • Phone: 213-284-3200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95015513
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: