Provider Demographics
NPI:1356566236
Name:DIAZ, JULIO CESAR (LCSW)
Entity type:Individual
Prefix:
First Name:JULIO
Middle Name:CESAR
Last Name:DIAZ
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6282 W DOVEWOOD LN
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93723-7661
Mailing Address - Country:US
Mailing Address - Phone:559-271-5499
Mailing Address - Fax:
Practice Address - Street 1:215 S 4TH ST
Practice Address - Street 2:
Practice Address - City:CHOWCHILLA
Practice Address - State:CA
Practice Address - Zip Code:93610-2818
Practice Address - Country:US
Practice Address - Phone:559-665-2947
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-16
Last Update Date:2014-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA295581041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical