Provider Demographics
NPI:1619667011
Name:SADDI, JULIAN (PMHNP-BC)
Entity type:Individual
Prefix:
First Name:JULIAN
Middle Name:
Last Name:SADDI
Suffix:
Gender:M
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17100 NORWALK BLVD. STE 110 #724
Mailing Address - Street 2:
Mailing Address - City:CERRITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90703
Mailing Address - Country:US
Mailing Address - Phone:323-230-0634
Mailing Address - Fax:
Practice Address - Street 1:17100 NORWALK BLVD. STE 110
Practice Address - Street 2:
Practice Address - City:CERRITOS
Practice Address - State:CA
Practice Address - Zip Code:90703
Practice Address - Country:US
Practice Address - Phone:323-230-0634
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-09
Last Update Date:2025-03-18
Deactivation Date:2024-03-21
Deactivation Code:
Reactivation Date:2024-07-09
Provider Licenses
StateLicense IDTaxonomies
CA95023894363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty