Healthcare Provider Details

I. General information

NPI: 1497247183
Provider Name (Legal Business Name): JULIENNE HOPE PAYAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/30/2018
Last Update Date: 05/01/2025
Certification Date: 05/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1120 WINSTON PL
EL PASO TX
79907-1428
US

IV. Provider business mailing address

1120 WINSTON PL
EL PASO TX
79907-1428
US

V. Phone/Fax

Practice location:
  • Phone: 915-401-1944
  • Fax:
Mailing address:
  • Phone: 915-401-1944
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-18-59981
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number0-25-16063
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: