Provider Demographics
NPI:1598389827
Name:BRIONEZ, JULIO (PHD)
Entity type:Individual
Prefix:DR
First Name:JULIO
Middle Name:
Last Name:BRIONEZ
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:JULIO
Other - Middle Name:
Other - Last Name:BRIONEZ LLC
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:823 GATEWAY CENTER WAY
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92102-4541
Mailing Address - Country:US
Mailing Address - Phone:619-515-2300
Mailing Address - Fax:
Practice Address - Street 1:8851 CENTER DR STE 312
Practice Address - Street 2:
Practice Address - City:LA MESA
Practice Address - State:CA
Practice Address - Zip Code:91942-3050
Practice Address - Country:US
Practice Address - Phone:619-515-2383
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-02
Last Update Date:2025-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY683103TC1900X
CA34719103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling