MEDICARE: BETTY DUONG

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	LCSW64549
2	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1235358367
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BETTY DUONG

Provider Business Mailing Address
First Line	:	8941 ATLANTA AVE # 357
Second Line	:
City	:	HUNTINGTON BEACH
State	:	CA
Zip	:	92646-7121
Country	:	US
Telephone Number	:	714-585-0165
Fax Number	:

Provider Business Practice Location Address
First Line	:	16152 BEACH BLVD STE 265
Second Line	:
City	:	HUNTINGTON BEACH
State	:	CA
Zip	:	92647-3864
Country	:	US
Telephone Number	:	714-585-0165
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/25/2007
Last Update Date	:	05/02/2018

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