Healthcare Provider Details

I. General information

NPI: 1073149662
Provider Name (Legal Business Name): JULEE LOCES LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/16/2020
Last Update Date: 06/07/2023
Certification Date: 06/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2069 N MAIN ST STE 101
CEDAR CITY UT
84721-5675
US

IV. Provider business mailing address

4193 FLAT ROCK DR STE 200-424
RIVERSIDE CA
92505-7111
US

V. Phone/Fax

Practice location:
  • Phone: 435-267-4212
  • Fax:
Mailing address:
  • Phone: 760-485-1282
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number11249783-3502
License Number StateUT
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number110353
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: