Bianca St Julian

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

2102803 Issued in TX

Practice address

4720 E Cotton Gin Loop
Phoenix, AZ 85040-4823

Phone

(877) 279-0891

NPI assigned

Jul 3, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1372809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610582400000",
    "number": "1013357060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5322 AVENUE J",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770112108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4720 E COTTON GIN LOOP",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850404823",
            "telephone_number": "877-279-0891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ST JULIAN",
        "first_name": "BIANCA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-07-03",
        "last_updated": "2021-01-14",
        "certification_date": "2021-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "TX",
            "license": "2102803",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00000000000",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "zzz",
            "affiliation": "N",
            "address_1": "4720 E Cotton Gin Loop",
            "city": "Phoenix",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "850404823",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Physical Therapy Assistant in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Physical Therapy Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.