Provider Demographics
NPI:1902011224
Name:CRUZ VAZQUEZ, JULIO A (1261P)
Entity type:Individual
Prefix:
First Name:JULIO
Middle Name:A
Last Name:CRUZ VAZQUEZ
Suffix:
Gender:M
Credentials:1261P
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:394 PLEASANT ST
Mailing Address - Street 2:
Mailing Address - City:NEW BEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:02740-5902
Mailing Address - Country:US
Mailing Address - Phone:774-770-0160
Mailing Address - Fax:
Practice Address - Street 1:965 CHURCH ST
Practice Address - Street 2:
Practice Address - City:NEW BEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02745-1400
Practice Address - Country:US
Practice Address - Phone:508-996-3154
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-11
Last Update Date:2025-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health