Healthcare Provider Details

I. General information

NPI: 1629199716
Provider Name (Legal Business Name): JULIO CESAR ARMENTA PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/03/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2901 MEADOW LARK DR
SAN DIEGO CA
92123-2711
US

IV. Provider business mailing address

PO BOX 143
BONITA CA
91908-0143
US

V. Phone/Fax

Practice location:
  • Phone: 619-694-4555
  • Fax:
Mailing address:
  • Phone: 619-470-3388
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY 13633
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code103TF0200X
TaxonomyForensic Psychologist
License NumberPSY 13633
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: