Provider Demographics
NPI:1235950940
Name:LE, JULIE UYEN (N/A)
Entity type:Individual
Prefix:MS
First Name:JULIE
Middle Name:UYEN
Last Name:LE
Suffix:
Gender:F
Credentials:N/A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:520 N LA BREA AVE
Mailing Address - Street 2:
Mailing Address - City:INGLEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90302-3049
Mailing Address - Country:US
Mailing Address - Phone:323-294-4932
Mailing Address - Fax:
Practice Address - Street 1:520 N LA BREA AVE
Practice Address - Street 2:
Practice Address - City:INGLEWOOD
Practice Address - State:CA
Practice Address - Zip Code:90302-3049
Practice Address - Country:US
Practice Address - Phone:323-294-4932
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-24
Last Update Date:2024-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMPSS-QHVBJO174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist