Healthcare Provider Details

I. General information

NPI: 1902518533
Provider Name (Legal Business Name): JULIA MATHEWS PT, NCS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/14/2022
Last Update Date: 09/04/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1354 STONEWOOD CT
SAN PEDRO CA
90732-1550
US

IV. Provider business mailing address

1354 STONEWOOD CT
SAN PEDRO CA
90732-1550
US

V. Phone/Fax

Practice location:
  • Phone: 310-720-5465
  • Fax:
Mailing address:
  • Phone: 310-720-5465
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number24543
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: