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NPI Code Detail

MEDICARE: EDWARD ALDEN DUQUETTE

MEDICARE: EDWARD ALDEN DUQUETTE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1144160243
Entity Type Code : Individual
Provider Name (Legal Business Name) : EDWARD ALDEN DUQUETTE
Provider Business Mailing Address
First Line : 1100 EVERTON PL APT 252
Second Line :
City : RIVERSIDE
State : CA
Zip : 92507-4475
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 21801 CACTUS AVE STE A
Second Line :
City : RIVERSIDE
State : CA
Zip : 92518-3020
Country : US
Telephone Number : 833-526-2333
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/30/2026
Last Update Date : 03/30/2026

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Directions to “ EDWARD ALDEN DUQUETTE ” Practice Location

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