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General NPI Number Information
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NPI Number | 1740100064
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Entity Type | Individual
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Provider Name | JULIE FENSKE MS, CCP, FPP
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Gender | Female
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Dates
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Enumeration Date | 07/17/2026
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Last Update Date | 07/17/2026
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Provider Practice Location Address
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Address Line | 1500 SAN PABLO ST # TO
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City | LOS ANGELES
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State | CA
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Zip | 90033-5313
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Country | US
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Telephone | 213-700-0109
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Fax |
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Provider Business Mailing Address
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Address Line | 1110 HACIENDA PL APT 102
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City | WEST HOLLYWOOD
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State | CA
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Zip | 90069-2738
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Country | US
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Telephone | 847-636-8897
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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 | 242T00000X
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Taxonomy Name | Perfusionist
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License Number | 179086-0444
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License Number State | CA
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