Individual provider Active NPI

Julie Nicole Therien, PA

  • Physician Assistant
  • San Francisco, CA
National Provider Identifier
1487240982
Registry record updated Dec 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA58930 Issued in CA
Practice address
2351 Clay St Ste 501
San Francisco, CA 94115-1931
Phone
(415) 600-3898
Fax
(415) 369-1380
NPI assigned
Dec 18, 2020
Last updated
Dec 14, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA58930 CA Primary
Surgical Physician Assistant 363AS0400X 58930 CA

Addresses

Primary practice location

2351 Clay St Ste 501
San Francisco, CA 94115-1931

Mailing address

325 Distel Cir
Los Altos, CA 94022-1408
Phone (415) 600-3898

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
I20210122001126 CA Practitioner - Physician Assistant 7719391358 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sutter Bay Medical FoundationGroup PAC ID 4284538778, 3,783 clinicians

Practice addresses (Care Compare)

1101 Van Ness Ave
San Francisco, CA 94109-6919
Phone (415) 600-6000

3838 California St
San Francisco, CA 94118-1506

601 Duboce Ave
San Francisco, CA 94117-3389

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
58930CAMDPharmacist
PA58930CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Sutter Bay Medical Foundation CurrentSince Dec 1, 2023 Accepting new patients
Sutter Bay Medical Foundation CurrentSince Dec 1, 2023 Accepting new patients

Locations

3200 Kearney St
Fremont, CA 94538
Phone (510) 498-2800

325 Distel Cir
Los Altos, CA 94022
Phone (510) 204-3977

795 El Camino Real
Palo Alto, CA 94301
Phone (650) 324-1832

2351 Clay St
Ste 501
San Francisco, CA 94115
Phone (415) 600-3898

3838 California St
Rm 410
San Francisco, CA 94118
Phone (415) 751-1847

3883 Airway Dr
Ste 220
Santa Rosa, CA 95403
Phone (707) 521-7750

550 S Green Valley Rd
Watsonville, CA 95076
Phone (831) 458-5865

Interoperability endpoints

  • Direct secure messaging: jtherien570666@hisp.ehr.sutterhealth.org

Organizations & group practices 3

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

Hospital & facility affiliations 3

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": "1608249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702512000000",
    "number": "1487240982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 DISTEL CIR",
            "city": "LOS ALTOS",
            "state": "CA",
            "postal_code": "940221408",
            "telephone_number": "415-600-3898",
            "fax_number": "415-369-1380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2351 CLAY ST STE 501",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941151931",
            "telephone_number": "415-600-3898",
            "fax_number": "415-369-1380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THERIEN",
        "first_name": "JULIE",
        "middle_name": "NICOLE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-18",
        "last_updated": "2023-12-14",
        "certification_date": "2023-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA58930",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CA",
            "license": "58930",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

Verify at the official NPI Registry.