Provider Demographics
NPI:1730735853
Name:BOTTING, JULIANA MARIA (PT, DPT, ATC)
Entity type:Individual
Prefix:DR
First Name:JULIANA
Middle Name:MARIA
Last Name:BOTTING
Suffix:
Gender:F
Credentials:PT, DPT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4438 VISTA DEL MONTE AVE APT 301
Mailing Address - Street 2:
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91403-3074
Mailing Address - Country:US
Mailing Address - Phone:818-203-9006
Mailing Address - Fax:
Practice Address - Street 1:10725 ZELZAH AVE # B
Practice Address - Street 2:
Practice Address - City:GRANADA HILLS
Practice Address - State:CA
Practice Address - Zip Code:91344-4431
Practice Address - Country:US
Practice Address - Phone:818-832-8383
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-14
Last Update Date:2019-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA296903225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist