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NPI Code Detail

MEDICARE: NANCY GUADALUPE DURON ASCW

MEDICARE: NANCY GUADALUPE DURON ASCW
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
1104100000XSocial Worker90383CA

General Provider Information

NPI Number : 1992494405
Entity Type Code : Individual
Provider Name (Legal Business Name) : NANCY GUADALUPE DURON ASCW
Provider Business Mailing Address
First Line : 1752 ELWOOD ST
Second Line :
City : POMONA
State : CA
Zip : 91768-1208
Country : US
Telephone Number : 909-436-6592
Fax Number :
Provider Business Practice Location Address
First Line : 601 5TH AVE
Second Line :
City : UPLAND
State : CA
Zip : 91786-4839
Country : US
Telephone Number : 909-949-6526
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/02/2023
Last Update Date : 06/20/2024

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