Provider Demographics
NPI:1518761980
Name:MACIAS, JULIAN A JR (RN)
Entity type:Individual
Prefix:
First Name:JULIAN
Middle Name:A
Last Name:MACIAS
Suffix:JR
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 W SPRING ST UNIT E
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90806-1464
Mailing Address - Country:US
Mailing Address - Phone:562-304-5825
Mailing Address - Fax:
Practice Address - Street 1:105 W SPRING ST UNIT E
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90806-1464
Practice Address - Country:US
Practice Address - Phone:562-304-5825
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-03
Last Update Date:2025-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95276479163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health