Provider Demographics
NPI:1194178509
Name:DUENAS, ALONSO
Entity type:Individual
Prefix:
First Name:ALONSO
Middle Name:
Last Name:DUENAS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6736 LAUREL CANYON BLVD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:NORTH HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:91606-1538
Mailing Address - Country:US
Mailing Address - Phone:818-755-8786
Mailing Address - Fax:818-755-8789
Practice Address - Street 1:6736 LAUREL CANYON BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:NORTH HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:91606-1538
Practice Address - Country:US
Practice Address - Phone:818-755-8786
Practice Address - Fax:818-755-8789
Is Sole Proprietor?:No
Enumeration Date:2016-07-20
Last Update Date:2016-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator