Active NPI
Julie Anya Broder, LAC
- Acupuncturist
- Boulder Creek, CA
National Provider Identifier
1578643862
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- CA6977
- Practice address
- 12704 Hwy 9
Boulder Creek, CA 95006 - Phone
- (831) 338-8033
- Fax
- (831) 338-8033
- NPI assigned
- Oct 17, 2006
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acupuncturist | 171100000X | CA6977 | CA | Primary |
Addresses
Primary practice location
12704 Hwy 9
Boulder Creek, CA 95006
Mailing address
PO Box 201
Boulder Creek, CA 95006
Phone (831) 338-8033
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CA6977 | CA | MD | Acupuncturist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161043200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1578643862",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 201",
"city": "BOULDER CREEK",
"state": "CA",
"postal_code": "95006",
"telephone_number": "831-338-8033",
"fax_number": "831-338-8033"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12704 HWY 9",
"city": "BOULDER CREEK",
"state": "CA",
"postal_code": "95006",
"telephone_number": "831-338-8033",
"fax_number": "831-338-8033"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRODER",
"first_name": "JULIE",
"middle_name": "ANYA",
"credential": "LAC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-17",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "CA",
"license": "CA6977",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boulder Creek, CA
- Heidi Ann Barclay Lee, L.AC., DIPL. ACU.
- BCRX Inc (Boulder Creek Pharmacy)
- Wilfred Douglas Benoit, MFT
- Boulder Creek Pharmacy
- Brian James Britton, PHARMACIST
- Patricia Brown, CCC-SLP
- Donna Lynn Childs, O.T.R
- Clary Sage Marriage and Family Therapy
- Dignity Health Medical Foundation (Dignity Health Medical Group - Dominican, a service of Dignity Health)
- Patricia Collins Dodge, PPS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.