MEDICARE: DR. ANGEL DUNCAN PSY.D.

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
1	103T00000X	Psychologist	PSY28174	CA

General Provider Information

NPI Number	:	1396192282
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANGEL DUNCAN PSY.D.

Provider Business Mailing Address
First Line	:	10153 1/2 RIVERSIDE DR STE 380
Second Line	:
City	:	TOLUCA LAKE
State	:	CA
Zip	:	91602-2561
Country	:	US
Telephone Number	:	818-659-1109
Fax Number	:

Provider Business Practice Location Address
First Line	:	745 S MARENGO AVE STE 200
Second Line	:
City	:	PASADENA
State	:	CA
Zip	:	91106-4738
Country	:	US
Telephone Number	:	818-658-1109
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/20/2016
Last Update Date	:	12/26/2016

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