Healthcare Provider Details

I. General information

NPI: 1336011881
Provider Name (Legal Business Name): JULIA CHANNEL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/23/2025
Last Update Date: 09/23/2025
Certification Date: 09/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3051 LITTLETON LN
ROSEVILLE CA
95747-9043
US

IV. Provider business mailing address

3051 LITTLETON LN
ROSEVILLE CA
95747-9043
US

V. Phone/Fax

Practice location:
  • Phone: 559-287-2300
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License Number571959
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: