Provider Demographics
NPI:1023146503
Name:CAMARGO, JULIO
Entity type:Individual
Prefix:
First Name:JULIO
Middle Name:
Last Name:CAMARGO
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 1:951 H DE LA VEGA DR
Mailing Address - Street 2:
Mailing Address - City:CALEXICO
Mailing Address - State:CA
Mailing Address - Zip Code:92231-6903
Mailing Address - Country:US
Mailing Address - Phone:760-768-1260
Mailing Address - Fax:
Practice Address - Street 1:2417 MARSHALL AVE STE 1
Practice Address - Street 2:
Practice Address - City:IMPERIAL
Practice Address - State:CA
Practice Address - Zip Code:92251-9401
Practice Address - Country:US
Practice Address - Phone:760-355-0161
Practice Address - Fax:760-355-2596
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
CA97632106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health