Provider Demographics
NPI:1063884393
Name:DAILY, JULIA ROSE (BCBA)
Entity type:Individual
Prefix:MRS
First Name:JULIA
Middle Name:ROSE
Last Name:DAILY
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:JULIA
Other - Middle Name:ROSE
Other - Last Name:TOUSSAINT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1684 CARMEL CIR E
Mailing Address - Street 2:
Mailing Address - City:UPLAND
Mailing Address - State:CA
Mailing Address - Zip Code:91784-1706
Mailing Address - Country:US
Mailing Address - Phone:408-761-1259
Mailing Address - Fax:
Practice Address - Street 1:1684 CARMEL CIR E
Practice Address - Street 2:
Practice Address - City:UPLAND
Practice Address - State:CA
Practice Address - Zip Code:91784-1706
Practice Address - Country:US
Practice Address - Phone:408-761-1259
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-26
Last Update Date:2015-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA11518973103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst