MEDICARE: ALEXIS NICOLE DUENES PEER

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	175T00000X	Peer Specialist		CA
2	225400000X	Rehabilitation Practitioner		CA

General Provider Information

NPI Number	:	1740019710
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEXIS NICOLE DUENES PEER

Provider Business Mailing Address
First Line	:	7830 CLAIREMONT MESA BLVD STE 100
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92111-1632
Country	:	US
Telephone Number	:	619-229-2999
Fax Number	:

Provider Business Practice Location Address
First Line	:	7830 CLAIREMONT MESA BLVD STE 100
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92111-1632
Country	:	US
Telephone Number	:	619-229-2999
Fax Number	:

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

Provider Enumeration Date	:	07/29/2024
Last Update Date	:	03/23/2026

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