Provider Demographics
NPI:1982034732
Name:KUKULKA, JULI ANNE (CAS II)
Entity Type:Individual
Prefix:MRS
First Name:JULI
Middle Name:ANNE
Last Name:KUKULKA
Suffix:
Gender:F
Credentials:CAS II
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Mailing Address - Street 1:2220 GIRARD ST
Mailing Address - Street 2:
Mailing Address - City:SAN JACINTO
Mailing Address - State:CA
Mailing Address - Zip Code:92583-5301
Mailing Address - Country:US
Mailing Address - Phone:951-925-8450
Mailing Address - Fax:951-658-6686
Practice Address - Street 1:2220 GIRARD ST
Practice Address - Street 2:
Practice Address - City:SAN JACINTO
Practice Address - State:CA
Practice Address - Zip Code:92583-5301
Practice Address - Country:US
Practice Address - Phone:951-925-8450
Practice Address - Fax:951-658-6686
Is Sole Proprietor?:No
Enumeration Date:2013-11-14
Last Update Date:2017-04-04
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)