Provider Demographics
NPI:1972153211
Name:DUZ, HICRAN
Entity type:Individual
Prefix:
First Name:HICRAN
Middle Name:
Last Name:DUZ
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 1:704 E SAN ANTONIO DR APT 4
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90807-2216
Mailing Address - Country:US
Mailing Address - Phone:562-330-8050
Mailing Address - Fax:
Practice Address - Street 1:704 E SAN ANTONIO DR APT 4
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90807-2216
Practice Address - Country:US
Practice Address - Phone:562-330-8050
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-18
Last Update Date:2019-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty