Healthcare Provider Details

I. General information

NPI: 1285844365
Provider Name (Legal Business Name): JULIUS JACINTO PT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/23/2007
Last Update Date: 05/15/2026
Certification Date: 05/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8550 BALBOA BLVD STE 242
NORTHRIDGE CA
91325-3593
US

IV. Provider business mailing address

500 E OLIVE AVE STE 325
BURBANK CA
91501-3316
US

V. Phone/Fax

Practice location:
  • Phone: 818-894-2273
  • Fax: 818-357-2505
Mailing address:
  • Phone: 818-955-5786
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number30229
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: