Provider Demographics
NPI:1932892544
Name:NERI ANDARDE, JULIO
Entity Type:Individual
Prefix:
First Name:JULIO
Middle Name:
Last Name:NERI ANDARDE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4450 CAPITOLA RD STE 106
Mailing Address - Street 2:
Mailing Address - City:CAPITOLA
Mailing Address - State:CA
Mailing Address - Zip Code:95010-3570
Mailing Address - Country:US
Mailing Address - Phone:831-359-6168
Mailing Address - Fax:
Practice Address - Street 1:4450 CAPITOLA RD STE 106
Practice Address - Street 2:
Practice Address - City:CAPITOLA
Practice Address - State:CA
Practice Address - Zip Code:95010-3570
Practice Address - Country:US
Practice Address - Phone:831-359-6168
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-30
Last Update Date:2023-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker