Healthcare Provider Details

I. General information

NPI: 1770635328
Provider Name (Legal Business Name): MS. JULIA-ANNE HARDIN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/16/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2178 JOHNSON AVE
SAN LUIS OBISPO CA
93401-4535
US

IV. Provider business mailing address

5105 DOLORES AVE
ATASCADERO CA
93422-2915
US

V. Phone/Fax

Practice location:
  • Phone: 805-788-2932
  • Fax: 805-781-1272
Mailing address:
  • Phone: 805-674-3979
  • Fax: 805-462-1578

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: