Provider Demographics
NPI:1225879448
Name:DUFOUR, STEVEN RAY JR
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:RAY
Last Name:DUFOUR
Suffix:JR
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 1:8675 FALMOUTH AVE APT 307
Mailing Address - Street 2:
Mailing Address - City:PLAYA DEL REY
Mailing Address - State:CA
Mailing Address - Zip Code:90293-8691
Mailing Address - Country:US
Mailing Address - Phone:213-393-2970
Mailing Address - Fax:
Practice Address - Street 1:21515 HAWTHORNE BLVD # GL100
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90503-6501
Practice Address - Country:US
Practice Address - Phone:858-304-6440
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-03
Last Update Date:2024-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician