Provider Demographics
NPI:1770298911
Name:J. QUIJADA NP - MENTAL HEALTH NURSING PROVIDER PC
Entity type:Organization
Organization Name:J. QUIJADA NP - MENTAL HEALTH NURSING PROVIDER PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JULIO
Authorized Official - Middle Name:
Authorized Official - Last Name:QUIJADA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-860-0133
Mailing Address - Street 1:800 S VICTORY BLVD STE 106
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91502-2489
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:800 S VICTORY BLVD STE 106
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91502-2489
Practice Address - Country:US
Practice Address - Phone:818-860-0133
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-23
Last Update Date:2023-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty