Healthcare Provider Details

I. General information

NPI: 1316871841
Provider Name (Legal Business Name): BRENDA JACQUELINE DUARTE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2026
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4836 MISSION ST
SAN FRANCISCO CA
94112-3414
US

IV. Provider business mailing address

2 GENEVA AVE APT 7
SAN FRANCISCO CA
94112-2363
US

V. Phone/Fax

Practice location:
  • Phone: 415-552-3870
  • Fax:
Mailing address:
  • Phone: 909-236-3813
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: