Doctor Name: | JOSE DE JESUS EULLOQUI |
NPI Number: | 1003170903 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | |
Business Practice Address: | 1255 Kendall Rd San Luis Obispo, CA - 934018750 |
Business Phone Number: | 8057813535 |
Business Fax Number: | |
Mailing Address: | 4036 Cedarhurst Dr Apt 208, SANTA MARIA |
State: | CA |
Postal Code: | 934556415 |
Phone Number: | 8052662945 |
Fax Number: | |
NPI Enumeration Date: | 06/26/2012 |
NPI Last Update Date: | 05/21/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |