Provider Demographics
NPI:1053012674
Name:CALKINS, JULLIE ANN
Entity type:Individual
Prefix:
First Name:JULLIE
Middle Name:ANN
Last Name:CALKINS
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 1:1300 HILLTOP DR STE 200
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96003-3874
Mailing Address - Country:US
Mailing Address - Phone:530-618-5621
Mailing Address - Fax:
Practice Address - Street 1:1300 HILLTOP DR STE 200
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96003-3874
Practice Address - Country:US
Practice Address - Phone:530-618-5621
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-10
Last Update Date:2023-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator