MEDICARE: JULIANA CAROLINE YAVORSKY DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	PT296677	CA

General Provider Information

NPI Number	:	1245690890
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIANA CAROLINE YAVORSKY DPT

Provider Business Mailing Address
First Line	:	42080 STATE ST STE A
Second Line	:
City	:	PALM DESERT
State	:	CA
Zip	:	92211-5173
Country	:	US
Telephone Number	:	760-568-2894
Fax Number	:	760-346-4179

Provider Business Practice Location Address
First Line	:	42080 STATE ST STE A
Second Line	:
City	:	PALM DESERT
State	:	CA
Zip	:	92211-5173
Country	:	US
Telephone Number	:	760-568-2894
Fax Number	:	760-346-4179

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/24/2016
Last Update Date	:	09/05/2024

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