Provider Demographics
NPI:1366841355
Name:JULIEN, CLARA
Entity type:Individual
Prefix:
First Name:CLARA
Middle Name:
Last Name:JULIEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2801 GREWAL PKWY APT 214
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95356-8015
Mailing Address - Country:US
Mailing Address - Phone:313-850-8017
Mailing Address - Fax:
Practice Address - Street 1:2336 SYLVAN AVE STE C
Practice Address - Street 2:
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95355-9211
Practice Address - Country:US
Practice Address - Phone:559-570-0605
Practice Address - Fax:855-583-3775
Is Sole Proprietor?:No
Enumeration Date:2014-08-15
Last Update Date:2024-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP95025998363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily