Healthcare Provider Details

I. General information

NPI: 1558054155
Provider Name (Legal Business Name): KAL ILYO DUVAL
Entity Type: Individual
Gender:
Sole Proprietor: N

Provider Other Name: KIMBERLY LOREN ALBERON

II. Dates (important events)

Enumeration Date: 05/30/2023
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2149 CENTENNIAL PLZ STE 4
EUGENE OR
97401-2456
US

IV. Provider business mailing address

78A CENTENNIAL LOOP
EUGENE OR
97401
US

V. Phone/Fax

Practice location:
  • Phone: 541-741-7107
  • Fax: 541-687-9279
Mailing address:
  • Phone: 541-741-7107
  • Fax: 541-687-9279

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: