Provider Demographics
NPI:1619381969
Name:JULE-FROST, VIRGINIA
Entity Type:Individual
Prefix:
First Name:VIRGINIA
Middle Name:
Last Name:JULE-FROST
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 1:729 WARFORD AVE
Mailing Address - Street 2:
Mailing Address - City:VALLEJO
Mailing Address - State:CA
Mailing Address - Zip Code:94591-4805
Mailing Address - Country:US
Mailing Address - Phone:925-270-9604
Mailing Address - Fax:
Practice Address - Street 1:2118 WILLOW PASS RD
Practice Address - Street 2:STE 500
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94520-2408
Practice Address - Country:US
Practice Address - Phone:925-692-0090
Practice Address - Fax:925-692-0091
Is Sole Proprietor?:No
Enumeration Date:2014-06-15
Last Update Date:2014-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist