Basic Information
| Provider Information | |||||||||
| NPI: | 1558317610 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LOPEZ | ||||||||
| FirstName: | JULIA | ||||||||
| MiddleName: | |||||||||
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| Credential: | NUTRITIONIST | ||||||||
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| Mailing Information | |||||||||
| Address1: | 801 W CENTER AVE | ||||||||
| Address2: | |||||||||
| City: | VISALIA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 932916013 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5597917049 | ||||||||
| FaxNumber: | 5597341247 | ||||||||
| Practice Location | |||||||||
| Address1: | 12586 AVENUE 408 | ||||||||
| Address2: | |||||||||
| City: | OROSI | ||||||||
| State: | CA | ||||||||
| PostalCode: | 936479454 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5595282804 | ||||||||
| FaxNumber: | 5595287623 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/26/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 133N00000X | Y | Dietary & Nutritional Service Providers | Nutritionist |
No ID Information.