Provider Demographics
NPI:1942894829
Name:ANGUIANO PEREZ, JULISSA (MSW, LSWAIC)
Entity Type:Individual
Prefix:
First Name:JULISSA
Middle Name:
Last Name:ANGUIANO PEREZ
Suffix:
Gender:F
Credentials:MSW, LSWAIC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2506 168TH PL NE
Mailing Address - Street 2:
Mailing Address - City:MARYSVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98271-4471
Mailing Address - Country:US
Mailing Address - Phone:425-217-8062
Mailing Address - Fax:
Practice Address - Street 1:2506 168TH PL NE
Practice Address - Street 2:
Practice Address - City:MARYSVILLE
Practice Address - State:WA
Practice Address - Zip Code:98271-4471
Practice Address - Country:US
Practice Address - Phone:425-217-8062
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-22
Last Update Date:2024-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WASC61126995101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health