Healthcare Provider Details

I. General information

NPI: 1225286156
Provider Name (Legal Business Name): JULIE MATHEW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/04/2008
Last Update Date: 09/18/2026
Certification Date: 09/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1310 W STEWART DR STE 306
ORANGE CA
92868-3838
US

IV. Provider business mailing address

3956 KIND WAY
YORBA LINDA CA
92886-6131
US

V. Phone/Fax

Practice location:
  • Phone: 724-545-5550
  • Fax:
Mailing address:
  • Phone: 714-717-1828
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number16697
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number16697
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number618177
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: