Provider Demographics
NPI:1689495921
Name:DUNCAN, LISA RENE (BUSINESS OWNER)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:RENE
Last Name:DUNCAN
Suffix:
Gender:F
Credentials:BUSINESS OWNER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 WILBUR AVE APT 2056
Mailing Address - Street 2:
Mailing Address - City:ANTIOCH
Mailing Address - State:CA
Mailing Address - Zip Code:94509-7538
Mailing Address - Country:US
Mailing Address - Phone:925-453-1939
Mailing Address - Fax:
Practice Address - Street 1:600 WILBUR AVE APT 2056
Practice Address - Street 2:
Practice Address - City:ANTIOCH
Practice Address - State:CA
Practice Address - Zip Code:94509-7538
Practice Address - Country:US
Practice Address - Phone:925-453-1939
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-19
Last Update Date:2024-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1744R1102XOther Service ProvidersSpecialistResearch Study
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
No146D00000XEmergency Medical Service ProvidersPersonal Emergency Response Attendant
No171400000XOther Service ProvidersHealth & Wellness Coach
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No172V00000XOther Service ProvidersCommunity Health Worker
No372600000XNursing Service Related ProvidersAdult Companion
No1744R1103XOther Service ProvidersSpecialistResearch Data Abstracter/Coder
No246Y00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Health Information
No247000000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Health Information
No373H00000XNursing Service Related ProvidersDay Training/Habilitation Specialist