Provider Demographics
NPI:1073266508
Name:MACHUCA, JULIO ALEXANDER (MS PLMHP)
Entity type:Individual
Prefix:
First Name:JULIO
Middle Name:ALEXANDER
Last Name:MACHUCA
Suffix:
Gender:M
Credentials:MS PLMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3514 S 153RD ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68144-5518
Mailing Address - Country:US
Mailing Address - Phone:402-714-5426
Mailing Address - Fax:
Practice Address - Street 1:8790 F ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68127-1524
Practice Address - Country:US
Practice Address - Phone:402-262-4808
Practice Address - Fax:844-895-1590
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-03
Last Update Date:2023-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health