Provider Demographics
NPI:1053810887
Name:DUENAS, MARIA CONCEPCION
Entity type:Individual
Prefix:MISS
First Name:MARIA
Middle Name:CONCEPCION
Last Name:DUENAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6801 COLDWATER CANYON AVE STE 1A
Mailing Address - Street 2:
Mailing Address - City:NORTH HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:91605-5163
Mailing Address - Country:US
Mailing Address - Phone:818-847-3841
Mailing Address - Fax:818-847-3923
Practice Address - Street 1:6801 COLDWATER CANYON AVE STE 1A
Practice Address - Street 2:
Practice Address - City:NORTH HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:91605-5163
Practice Address - Country:US
Practice Address - Phone:818-847-3841
Practice Address - Fax:818-847-3923
Is Sole Proprietor?:No
Enumeration Date:2018-02-07
Last Update Date:2018-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker