Provider Demographics
NPI:1053349290
Name:VALDESPINO, JULIAN (LCDC)
Entity type:Individual
Prefix:
First Name:JULIAN
Middle Name:
Last Name:VALDESPINO
Suffix:
Gender:M
Credentials:LCDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 MONTANA AVE
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79902-5411
Mailing Address - Country:US
Mailing Address - Phone:915-534-7227
Mailing Address - Fax:915-544-1997
Practice Address - Street 1:1001 MONTANA AVE
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79902-5411
Practice Address - Country:US
Practice Address - Phone:915-534-7227
Practice Address - Fax:915-544-1997
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7325101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)