Provider Demographics
NPI:1356404602
Name:JULES, JOSEPH EXNICIOUS (LPT)
Entity type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:EXNICIOUS
Last Name:JULES
Suffix:
Gender:M
Credentials:LPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1312 E GARLAND AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93704-4938
Mailing Address - Country:US
Mailing Address - Phone:559-222-4152
Mailing Address - Fax:
Practice Address - Street 1:1312 E GARLAND AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93704-4938
Practice Address - Country:US
Practice Address - Phone:559-222-4152
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA25530167G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes167G00000XNursing Service ProvidersLicensed Psychiatric Technician