Provider Demographics
NPI:1669363206
Name:DURAN, RICARDO DIEGO
Entity type:Individual
Prefix:
First Name:RICARDO
Middle Name:DIEGO
Last Name:DURAN
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 1:3504 OASIS SPRINGS RD NE
Mailing Address - Street 2:
Mailing Address - City:RIO RANCHO
Mailing Address - State:NM
Mailing Address - Zip Code:87144-2583
Mailing Address - Country:US
Mailing Address - Phone:505-318-6914
Mailing Address - Fax:
Practice Address - Street 1:3504 OASIS SPRINGS RD NE
Practice Address - Street 2:
Practice Address - City:RIO RANCHO
Practice Address - State:NM
Practice Address - Zip Code:87144-2583
Practice Address - Country:US
Practice Address - Phone:505-318-6914
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-11
Last Update Date:2025-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician