Provider Demographics
NPI:1003935735
Name:PATRON, JULIO
Entity Type:Individual
Prefix:
First Name:JULIO
Middle Name:
Last Name:PATRON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:721 E MAGNOLIA BLVD
Mailing Address - Street 2:UNIT E
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91501-1941
Mailing Address - Country:US
Mailing Address - Phone:818-355-0425
Mailing Address - Fax:
Practice Address - Street 1:721 E MAGNOLIA BLVD
Practice Address - Street 2:UNIT E
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91501-1941
Practice Address - Country:US
Practice Address - Phone:818-355-0425
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor