Provider Demographics
NPI:1487540845
Name:CAMPOS, JULIANA EMILIA
Entity type:Individual
Prefix:
First Name:JULIANA
Middle Name:EMILIA
Last Name:CAMPOS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 COURT ST STE 210
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:CA
Mailing Address - Zip Code:95642-2163
Mailing Address - Country:US
Mailing Address - Phone:209-257-1980
Mailing Address - Fax:209-257-1989
Practice Address - Street 1:601 COURT ST STE 210
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:CA
Practice Address - Zip Code:95642-2163
Practice Address - Country:US
Practice Address - Phone:209-257-1980
Practice Address - Fax:209-257-1989
Is Sole Proprietor?:No
Enumeration Date:2025-06-13
Last Update Date:2025-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist