MEDICARE: MRS. JULIA ELIZABETH REISCHL NP

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	163W00000X	Registered Nurse	845654	CA
2	363LF0000X	Family Nurse Practitioner	95034502	CA

General Provider Information

NPI Number	:	1376221390
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JULIA ELIZABETH REISCHL NP

Provider Business Mailing Address
First Line	:	3400 DATA DR
Second Line	:	ATTENTION: CREDENTIALING AND PAYER ENROLLMENT DEPT
City	:	RANCHO CORDOVA
State	:	CA
Zip	:	95670
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	575 AUTO CENTER DR
Second Line	:
City	:	WATSONVILLE
State	:	CA
Zip	:	95076-3727
Country	:	US
Telephone Number	:	831-288-6537
Fax Number	:	831-722-2855

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

Provider Enumeration Date	:	07/10/2023
Last Update Date	:	01/22/2026

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