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General NPI Number Information
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NPI Number | 1558698399
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Entity Type | Individual
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Provider Name | JULIE NIEDENS PA-C
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Gender | Female
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Dates
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Enumeration Date | 11/16/2009
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Last Update Date | 08/27/2010
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Provider Practice Location Address
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Address Line | 1685 E MAIN ST STE 301
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City | EL CAJON
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State | CA
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Zip | 92021-5292
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Country | US
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Telephone | 619-881-4568
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Fax | 619-442-6398
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Provider Business Mailing Address
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Address Line | 2353 FARRINGTON DR
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City | EL CAJON
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State | CA
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Zip | 92020-1077
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Country | US
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Telephone | 619-368-6586
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA20451
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License Number State | CA
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