Healthcare Provider Details

I. General information

NPI: 1689430233
Provider Name (Legal Business Name): CLAUDIA DUVAL APCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/22/2024
Last Update Date: 03/26/2024
Certification Date: 03/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12501 PHILADELPHIA ST
WHITTIER CA
90601-3900
US

IV. Provider business mailing address

1826 BOLKER PL
SAN PEDRO CA
90731-1225
US

V. Phone/Fax

Practice location:
  • Phone: 562-567-7417
  • Fax:
Mailing address:
  • Phone: 310-528-7495
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number15283
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number15283
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: