Provider Demographics
NPI:1902125248
Name:SANFILIPPO, JULIA (LAC)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:
Last Name:SANFILIPPO
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7946 IVANHOE AVE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92037-4516
Mailing Address - Country:US
Mailing Address - Phone:203-449-7510
Mailing Address - Fax:
Practice Address - Street 1:7946 IVANHOE AVE
Practice Address - Street 2:SUITE 202
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037-4516
Practice Address - Country:US
Practice Address - Phone:203-449-7510
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-26
Last Update Date:2010-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA13701171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist