Provider Demographics
NPI:1467324061
Name:QUIATCHON, JUANPAULO GANA
Entity type:Individual
Prefix:MR
First Name:JUANPAULO
Middle Name:GANA
Last Name:QUIATCHON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1690 UNIVERSE CIR
Mailing Address - Street 2:
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93033-2441
Mailing Address - Country:US
Mailing Address - Phone:805-277-1928
Mailing Address - Fax:
Practice Address - Street 1:1332 W DATE ST
Practice Address - Street 2:
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93033-3066
Practice Address - Country:US
Practice Address - Phone:805-277-1928
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-22
Last Update Date:2025-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician