Healthcare Provider Details

I. General information

NPI: 1295234136
Provider Name (Legal Business Name): DAYANARA PAULETTE DUARTE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/06/2018
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1414 S MILLER ST STE 5
SANTA MARIA CA
93454-6961
US

IV. Provider business mailing address

1846 ALMONDWOOD PL
LODI CA
95240-8854
US

V. Phone/Fax

Practice location:
  • Phone: 805-460-3623
  • Fax:
Mailing address:
  • Phone: 707-479-5268
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-26-88779
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: