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General NPI Number Information
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NPI Number | 1700311453
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Entity Type | Individual
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Provider Name | JULIA S PELTON PA-C
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Gender | Female
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Dates
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Enumeration Date | 05/01/2017
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Last Update Date | 12/01/2025
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Provider Practice Location Address
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Address Line | 3095 OLD CONEJO RD STE 224
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City | THOUSAND OAKS
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State | CA
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Zip | 91320-2130
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Country | US
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Telephone | 888-367-1850
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Fax | 805-222-0323
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Provider Business Mailing Address
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Address Line | 19562 SE INSTITUTION DR
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City | BLOUNTSTOWN
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State | FL
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Zip | 32424-5156
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Country | US
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Telephone | 850-237-6500
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Fax | 850-237-6567
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 0110005734
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 0110005734
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License Number State | VA
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