Provider Demographics
NPI:1134704216
Name:LOZANO CEJA, JULIA ALEJANDRA
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:ALEJANDRA
Last Name:LOZANO CEJA
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 1:1550 N D ST STE D
Mailing Address - Street 2:
Mailing Address - City:SAN BERNARDINO
Mailing Address - State:CA
Mailing Address - Zip Code:92405-4720
Mailing Address - Country:US
Mailing Address - Phone:909-515-2559
Mailing Address - Fax:
Practice Address - Street 1:1550 N D ST STE D
Practice Address - Street 2:
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92405-4720
Practice Address - Country:US
Practice Address - Phone:909-515-2559
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-10
Last Update Date:2024-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA142254106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist