Healthcare Provider Details

I. General information

NPI: 1750183349
Provider Name (Legal Business Name): PAOLA DE JESUS DUARTE PINEDA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2025
Last Update Date: 04/29/2025
Certification Date: 04/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

90 W ASHLAN AVE STE 100
CLOVIS CA
93612-5627
US

IV. Provider business mailing address

90 W ASHLAN AVE STE 10090W
CLOVIS CA
93612-5627
US

V. Phone/Fax

Practice location:
  • Phone: 559-882-5569
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberASW128853
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: