Provider Demographics
NPI:1629022389
Name:ALMANZA, JULIANA CASILLAS (FNP)
Entity Type:Individual
Prefix:MRS
First Name:JULIANA
Middle Name:CASILLAS
Last Name:ALMANZA
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:MISS
Other - First Name:JULIANA
Other - Middle Name:
Other - Last Name:CASILLAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:3369 RIDGE PARK CT
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90804-1201
Mailing Address - Country:US
Mailing Address - Phone:562-498-5709
Mailing Address - Fax:
Practice Address - Street 1:2699 ATLANTIC AVE
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90806-2710
Practice Address - Country:US
Practice Address - Phone:562-426-3333
Practice Address - Fax:562-426-3653
Is Sole Proprietor?:No
Enumeration Date:2006-05-19
Last Update Date:2012-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA622826163WG0000X
CA15946363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice