Basic Information
| Provider Information | |||||||||
| NPI: | 1437573250 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | STEVENS | ||||||||
| FirstName: | JULIE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1401 AVOCADO AVE | ||||||||
| Address2: | SUITE 709 | ||||||||
| City: | NEWPORT BEACH | ||||||||
| State: | CA | ||||||||
| PostalCode: | 926607720 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9497591720 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1401 AVOCADO AVE | ||||||||
| Address2: | SUITE 709 | ||||||||
| City: | NEWPORT BEACH | ||||||||
| State: | CA | ||||||||
| PostalCode: | 926607720 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9497591720 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/13/2014 | ||||||||
| LastUpdateDate: | 02/13/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LP0200X | 233847 | CA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Pediatrics |
No ID Information.