Provider Demographics
NPI:1104553452
Name:DURON, VERONICA MICHELLE
Entity type:Individual
Prefix:
First Name:VERONICA
Middle Name:MICHELLE
Last Name:DURON
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 1:3900 FIR TREE DR APT 2A
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92505-3563
Mailing Address - Country:US
Mailing Address - Phone:562-294-9808
Mailing Address - Fax:
Practice Address - Street 1:3900 FIR TREE DR APT 2A
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92505-3563
Practice Address - Country:US
Practice Address - Phone:562-294-9808
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-05
Last Update Date:2022-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty