Provider Demographics
NPI:1427402619
Name:GROVA, JULIO A (LCSW)
Entity Type:Individual
Prefix:
First Name:JULIO
Middle Name:A
Last Name:GROVA
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:JULIO
Other - Middle Name:A
Other - Last Name:GROVA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:PO BOX 7953
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92513-7953
Mailing Address - Country:US
Mailing Address - Phone:951-858-1964
Mailing Address - Fax:
Practice Address - Street 1:10800 HOLE AVE STE 17
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92505-2761
Practice Address - Country:US
Practice Address - Phone:951-382-4789
Practice Address - Fax:951-351-2722
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-14
Last Update Date:2019-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCSW295501041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical