Provider Demographics
NPI:1639588817
Name:QUIJADA, JULIO ALBERTO (PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:JULIO
Middle Name:ALBERTO
Last Name:QUIJADA
Suffix:
Gender:M
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 S VICTORY BLVD STE 106
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91502-2489
Mailing Address - Country:US
Mailing Address - Phone:818-860-0133
Mailing Address - Fax:818-860-0134
Practice Address - Street 1:800 S VICTORY BLVD STE 106
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91502-2489
Practice Address - Country:US
Practice Address - Phone:818-860-0133
Practice Address - Fax:818-860-0134
Is Sole Proprietor?:No
Enumeration Date:2014-08-12
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95021441363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health