Individual provider Active NPI

Julie Dutton, NP

  • Gerontology Nurse Practitioner
  • San Jose, CA
National Provider Identifier
1013136423
Registry record updated Aug 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
455229 Issued in CA
Practice address
4855 Atherton Ave Ste 101
San Jose, CA 95130-1026
Phone
(408) 963-2400
Fax
(408) 963-2472
NPI assigned
Apr 24, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 455229 CA Primary

Addresses

Primary practice location

4855 Atherton Ave Ste 101
San Jose, CA 95130-1026

Mailing address

12900 Park Plaza Dr Ste 150
Cerritos, CA 90703-9329
Phone (562) 977-4639

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090227000435 CA Practitioner - Nurse Practitioner 3971669847 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of California, San Francisco School of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

132 Carlyn Ave
Campbell, CA 95008-1916

2110 McKee Rd
San Jose, CA 95116-1427

2592 N Santiago Blvd
Orange, CA 92867-1862

Hospital & facility affiliations

  • Ascension Healthcare Services Home health agency, Campbell, CA, CCN 059765
  • Anx Home Healthcare Home health agency, Burlingame, CA, CCN 059071

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
455229CAMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Albion Medical Partners of California West P C CurrentSince Feb 1, 2021 Accepting new patients
Verity Medical Foundation CurrentSince Dec 26, 2017 Accepting new patients
DCHS Medical Foundation CurrentSince Dec 26, 2017 Accepting new patients
J M Geiss DO Apc CurrentSince Jan 15, 2024 Accepting new patients
Woods and Warshal Medical Group Inc CurrentSince Jun 24, 2017 Accepting new patients
California PHS PC CurrentSince Jan 1, 2024 Accepting new patients

Locations

12900 Park Plaza Dr
Ste 150
Cerritos, CA 90703
Phone (562) 622-2800

12900 Park Plaza Dr
Ste 700
Cerritos, CA 90703
Phone (562) 622-2800

1420 E Palomar St
Chula Vista, CA 91913

7638 N Ingram Ave
#111A
Fresno, CA 93711

3415 S Sepulveda Blvd
Ste 1100
Los Angeles, CA 90034
Phone (424) 348-4558

15251 National Ave
Ste 104
Los Gatos, CA 95032
Phone (408) 358-7360

1900 Coffee Rd
Modesto, CA 95355
Phone (209) 491-0904

25455 Medical Center Dr
Ste 200
Murrieta, CA 92562
Phone (951) 894-7056

520 Superior Ave
Ste 255
Newport Beach, CA 92663
Phone (949) 720-9266

2592 N Santiago Blvd
Orange, CA 92867
Phone (714) 577-2271

3550 Churn Creek Rd
Redding, CA 96002
Phone (530) 222-3630

5 Hutton Centre Dr
Ste 950
Santa Ana, CA 92707
Phone (855) 434-7663

28650 Newhall Ranch Rd
Santa Clarita, CA 91355
Phone (661) 347-0051

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • FHIR API: https://api.platform.athenahealth.com/19831/brand/2/csg/1/fhir/r4

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567123200000",
    "number": "1013136423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12900 PARK PLAZA DR STE 150",
            "city": "CERRITOS",
            "state": "CA",
            "postal_code": "907039329",
            "telephone_number": "562-977-4639",
            "fax_number": "562-741-4479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4855 ATHERTON AVE STE 101",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951301026",
            "telephone_number": "408-963-2400",
            "fax_number": "408-963-2472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUTTON",
        "first_name": "JULIE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-24",
        "last_updated": "2019-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "CA",
            "license": "455229",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

Verify at the official NPI Registry.