Provider Demographics
NPI:1306354584
Name:DURON, LUCIA
Entity type:Individual
Prefix:
First Name:LUCIA
Middle Name:
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 1:111 CURRITUCK COMMERICAL DR STE A1
Mailing Address - Street 2:
Mailing Address - City:MOYOCK
Mailing Address - State:NC
Mailing Address - Zip Code:27958-9086
Mailing Address - Country:US
Mailing Address - Phone:252-435-1665
Mailing Address - Fax:252-435-1665
Practice Address - Street 1:11760 KISMET RD
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92128-5010
Practice Address - Country:US
Practice Address - Phone:252-435-1665
Practice Address - Fax:252-435-2111
Is Sole Proprietor?:No
Enumeration Date:2018-01-22
Last Update Date:2022-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106S00000X
CA1-22-60767103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician