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General NPI Number Information
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NPI Number | 1174154595
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Entity Type | Organization
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Legal Business Name | KATHLEEN DUNCAN
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Dates
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Enumeration Date | 02/04/2020
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Last Update Date | 08/11/2020
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Provider Practice Location Address
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Address Line | 25020 LAS BRISAS RD STE 207
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City | MURRIETA
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State | CA
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Zip | 92562-4064
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Country | US
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Telephone | 951-708-0363
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Fax |
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Provider Business Mailing Address
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Address Line | 23096 BLUE BIRD DR
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City | CANYON LAKE
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State | CA
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Zip | 92587-7556
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Country | US
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Telephone | 951-708-0363
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | KATHLEEN DUNCAN
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Credential | LMFT
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Telephone | 951-708-0363
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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