Provider Demographics
NPI:1538450259
Name:COUDOUX, JULIE ANN (MP)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:ANN
Last Name:COUDOUX
Suffix:
Gender:F
Credentials:MP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1820 MELROSE DR
Mailing Address - Street 2:#331
Mailing Address - City:SAN MARCOS
Mailing Address - State:CA
Mailing Address - Zip Code:92078-2116
Mailing Address - Country:US
Mailing Address - Phone:760-805-2568
Mailing Address - Fax:
Practice Address - Street 1:1991 VILLAGE PARK WAY
Practice Address - Street 2:SUITE 206-A
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-1994
Practice Address - Country:US
Practice Address - Phone:760-805-2568
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-28
Last Update Date:2011-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist