Healthcare Provider Details

I. General information

NPI: 1134917347
Provider Name (Legal Business Name): JULIO MORALES CRUZ
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/28/2025
Last Update Date: 04/28/2025
Certification Date: 04/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

154 CAPP ST # A
SAN FRANCISCO CA
94110-1210
US

IV. Provider business mailing address

50 CASTILLO ST
SAN FRANCISCO CA
94134-3105
US

V. Phone/Fax

Practice location:
  • Phone: 415-826-6767
  • Fax: 415-826-6774
Mailing address:
  • Phone: 415-340-9605
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: