Provider Demographics
NPI:1558054155
Name:DUVAL, KAL ILYO
Entity type:Individual
Prefix:
First Name:KAL
Middle Name:ILYO
Last Name:DUVAL
Suffix:
Gender:X
Credentials:
Other - Prefix:
Other - First Name:KIMBERLY
Other - Middle Name:LOREN
Other - Last Name:ALBERON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:78A CENTENNIAL LOOP
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401
Mailing Address - Country:US
Mailing Address - Phone:541-741-7107
Mailing Address - Fax:541-687-9279
Practice Address - Street 1:2149 CENTENNIAL PLZ STE 4
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-2456
Practice Address - Country:US
Practice Address - Phone:541-741-7107
Practice Address - Fax:541-687-9279
Is Sole Proprietor?:No
Enumeration Date:2023-05-30
Last Update Date:2025-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No175T00000XOther Service ProvidersPeer Specialist