Healthcare Provider Details

I. General information

NPI: 1083172944
Provider Name (Legal Business Name): JULIE ANN HOLDRIDGE-PRADO BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/08/2019
Last Update Date: 03/08/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4324 RAMONA DR
RIVERSIDE CA
92506-1178
US

IV. Provider business mailing address

4324 RAMONA DR
RIVERSIDE CA
92506-1178
US

V. Phone/Fax

Practice location:
  • Phone: 951-743-5138
  • Fax:
Mailing address:
  • Phone: 951-743-5138
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: