Provider Demographics
NPI:1164939427
Name:OCAMPO, JULIETA G
Entity Type:Individual
Prefix:
First Name:JULIETA
Middle Name:G
Last Name:OCAMPO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:445 N SAN JOAQUIN ST
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95202-2026
Mailing Address - Country:US
Mailing Address - Phone:209-444-8910
Mailing Address - Fax:209-444-8905
Practice Address - Street 1:445 N SAN JOAQUIN ST
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95202-2026
Practice Address - Country:US
Practice Address - Phone:209-444-8910
Practice Address - Fax:209-444-8905
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-08
Last Update Date:2018-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor