Provider Demographics
NPI:1295333953
Name:JOHNSTON, JULIA MARIE (RD)
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:MARIE
Last Name:JOHNSTON
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:JULIA
Other - Middle Name:MARIE
Other - Last Name:CHANDLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD
Mailing Address - Street 1:3020 CHILDREN'S WAY
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92123-4223
Mailing Address - Country:US
Mailing Address - Phone:858-576-1700
Mailing Address - Fax:858-966-7732
Practice Address - Street 1:3020 CHILDREN'S WAY
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123-4223
Practice Address - Country:US
Practice Address - Phone:858-576-1700
Practice Address - Fax:858-966-7732
Is Sole Proprietor?:No
Enumeration Date:2020-10-14
Last Update Date:2023-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
133V00000X
CA86130385133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered