Healthcare Provider Details

I. General information

NPI: 1689097602
Provider Name (Legal Business Name): JO DUKE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: DONA JOSEPHA DUKE MFTI

II. Dates (important events)

Enumeration Date: 01/27/2014
Last Update Date: 01/27/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2730 SALVIO ST
CONCORD CA
94519-2599
US

IV. Provider business mailing address

6240 WHITSETT AVE APT 104
NORTH HOLLYWOOD CA
91606-3162
US

V. Phone/Fax

Practice location:
  • Phone: 925-687-0374
  • Fax: 925-687-2695
Mailing address:
  • Phone: 818-825-6040
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number75707
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: