Provider Demographics
NPI:1447514575
Name:SCHMIDT, JULIA IRENE (SLP)
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:IRENE
Last Name:SCHMIDT
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:I
Other - Last Name:CRUMMY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4295 ARCTURUS AVE
Mailing Address - Street 2:
Mailing Address - City:LOMPOC
Mailing Address - State:CA
Mailing Address - Zip Code:93436-1249
Mailing Address - Country:US
Mailing Address - Phone:805-588-3381
Mailing Address - Fax:
Practice Address - Street 1:191 BURTON MESA BLVD
Practice Address - Street 2:SUITE B
Practice Address - City:LOMPOC
Practice Address - State:CA
Practice Address - Zip Code:93436-1400
Practice Address - Country:US
Practice Address - Phone:805-733-4392
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-03
Last Update Date:2012-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPE7282235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist