Healthcare Provider Details

I. General information

NPI: 1053283473
Provider Name (Legal Business Name): JULIA PANIAGUA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/23/2025
Last Update Date: 09/23/2025
Certification Date: 09/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1520 N RAYMOND AVE
PASADENA CA
91103-1819
US

IV. Provider business mailing address

351 S HUDSON AVE
PASADENA CA
91101-3599
US

V. Phone/Fax

Practice location:
  • Phone: 626-396-5840
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number102763
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: