=====================================================
General NPI Number Information
=====================================================
NPI Number | 1235767393
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JULIANNE VILARDI-ZELINKA RN, PMHNP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/01/2020
-----------------------------------------------------
Last Update Date | 01/17/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 207 JUNIPERO CT
-----------------------------------------------------
City | CAPITOLA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95010-3724
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 831-202-3228
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 207 JUNIPERO CT
-----------------------------------------------------
City | CAPITOLA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95010-3724
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 831-202-3228
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LP0808X
-----------------------------------------------------
Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
-----------------------------------------------------
License Number | NPF6878
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------