Provider Demographics
NPI:1417726712
Name:CLEOPE, JOSH LEE
Entity Type:Individual
Prefix:
First Name:JOSH
Middle Name:LEE
Last Name:CLEOPE
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 1:25342 ASPEN GLEN AVE
Mailing Address - Street 2:
Mailing Address - City:MORENO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92551-2410
Mailing Address - Country:US
Mailing Address - Phone:951-640-2287
Mailing Address - Fax:
Practice Address - Street 1:25342 ASPEN GLEN AVE
Practice Address - Street 2:
Practice Address - City:MORENO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92551-2410
Practice Address - Country:US
Practice Address - Phone:951-640-2287
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-27
Last Update Date:2023-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician