Provider Demographics
NPI:1124372735
Name:ALANIZ, JUAN JESUS (MASTERS DEGREE/CREDE)
Entity Type:Individual
Prefix:MR
First Name:JUAN
Middle Name:JESUS
Last Name:ALANIZ
Suffix:
Gender:M
Credentials:MASTERS DEGREE/CREDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3221 AMETHYST WAY
Mailing Address - Street 2:
Mailing Address - City:TURLOCK
Mailing Address - State:CA
Mailing Address - Zip Code:95382-9217
Mailing Address - Country:US
Mailing Address - Phone:209-620-7855
Mailing Address - Fax:
Practice Address - Street 1:3221 AMETHYST WAY
Practice Address - Street 2:
Practice Address - City:TURLOCK
Practice Address - State:CA
Practice Address - Zip Code:95382-9217
Practice Address - Country:US
Practice Address - Phone:209-620-7855
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-05
Last Update Date:2012-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral
No101Y00000XBehavioral Health & Social Service ProvidersCounselor