Provider Demographics
NPI:1396577391
Name:ARENAS VELASQUEZ, JULIANA PAOLA (PA-C)
Entity type:Individual
Prefix:
First Name:JULIANA
Middle Name:PAOLA
Last Name:ARENAS VELASQUEZ
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:925 THE ALAMEDA UNIT 117
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95126-3182
Mailing Address - Country:US
Mailing Address - Phone:770-778-2323
Mailing Address - Fax:
Practice Address - Street 1:910 CAMPISI WAY STE 2A
Practice Address - Street 2:
Practice Address - City:CAMPBELL
Practice Address - State:CA
Practice Address - Zip Code:95008-2351
Practice Address - Country:US
Practice Address - Phone:408-827-4274
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-17
Last Update Date:2024-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA64703363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant