Provider Demographics
NPI:1437886488
Name:REGALADO, JULIA GLICERIA
Entity type:Individual
Prefix:
First Name:JULIA GLICERIA
Middle Name:
Last Name:REGALADO
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 1:2100 WEBSTER ST STE 225
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94115-2376
Mailing Address - Country:US
Mailing Address - Phone:415-923-3012
Mailing Address - Fax:415-928-4840
Practice Address - Street 1:2100 WEBSTER ST STE 225
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-2376
Practice Address - Country:US
Practice Address - Phone:415-923-3012
Practice Address - Fax:415-928-4840
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-01
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95034414363L00000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner