Healthcare Provider Details

I. General information

NPI: 1467285130
Provider Name (Legal Business Name): STEVE DUARTE
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/20/2024
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2670 W 11TH ST
LOS ANGELES CA
90006-2755
US

IV. Provider business mailing address

11586 ACALA AVE
SAN FERNANDO CA
91340-4172
US

V. Phone/Fax

Practice location:
  • Phone: 213-413-9600
  • Fax:
Mailing address:
  • Phone: 818-915-4527
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number230202696
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: