Healthcare Provider Details

I. General information

NPI: 1871379990
Provider Name (Legal Business Name): JULI MARKHAM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/05/2023
Last Update Date: 09/05/2023
Certification Date: 09/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23497 CORNUCOPIA WAY
WILDOMAR CA
92595-7400
US

IV. Provider business mailing address

23497 CORNUCOPIA WAY
WILDOMAR CA
92595-7400
US

V. Phone/Fax

Practice location:
  • Phone: 951-514-8824
  • Fax:
Mailing address:
  • Phone: 951-514-8824
  • Fax: 951-346-3659

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code247000000X
TaxonomyHealth Information Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: