Healthcare Provider Details

I. General information

NPI: 1568302610
Provider Name (Legal Business Name): RONIJOY DURAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/30/2026
Last Update Date: 04/01/2026
Certification Date: 04/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1260 E ARROW HWY BLDG C
UPLAND CA
91786-4987
US

IV. Provider business mailing address

435 W GLADSTONE ST UNIT 451G
GLENDORA CA
91740-5528
US

V. Phone/Fax

Practice location:
  • Phone: 909-608-2002
  • Fax:
Mailing address:
  • Phone: 909-251-8254
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number25449
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: