Provider Demographics
NPI:1679449128
Name:SISNEROS, JULIANA
Entity type:Individual
Prefix:
First Name:JULIANA
Middle Name:
Last Name:SISNEROS
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 1:35893 CHERRY ST
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:CA
Mailing Address - Zip Code:94560-1722
Mailing Address - Country:US
Mailing Address - Phone:510-946-9165
Mailing Address - Fax:
Practice Address - Street 1:650 S 5TH ST
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95112-5636
Practice Address - Country:US
Practice Address - Phone:408-457-6284
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-10-13
Last Update Date:2025-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health