Provider Demographics
NPI:1003793738
Name:SAMARIN, JULIA
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:
Last Name:SAMARIN
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 1:250 W 1ST ST STE 214
Mailing Address - Street 2:
Mailing Address - City:CLAREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:91711-4743
Mailing Address - Country:US
Mailing Address - Phone:909-935-9953
Mailing Address - Fax:
Practice Address - Street 1:17581 IRVINE BLVD STE 114
Practice Address - Street 2:
Practice Address - City:TUSTIN
Practice Address - State:CA
Practice Address - Zip Code:92780-3123
Practice Address - Country:US
Practice Address - Phone:949-503-1414
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-15
Last Update Date:2025-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95036233363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health