Provider Demographics
NPI:1427640291
Name:TALANCON, JULIO CESAR
Entity type:Individual
Prefix:
First Name:JULIO
Middle Name:CESAR
Last Name:TALANCON
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 1:415 PINE ST # 2B
Mailing Address - Street 2:
Mailing Address - City:REDWOOD CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94063-5420
Mailing Address - Country:US
Mailing Address - Phone:650-720-3949
Mailing Address - Fax:
Practice Address - Street 1:415 PINE ST # 2B
Practice Address - Street 2:
Practice Address - City:REDWOOD CITY
Practice Address - State:CA
Practice Address - Zip Code:94063-5420
Practice Address - Country:US
Practice Address - Phone:650-720-3949
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-03
Last Update Date:2021-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician