Provider Demographics
NPI:1992494405
Name:DURON, NANCY GUADALUPE (ASCW)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:GUADALUPE
Last Name:DURON
Suffix:
Gender:F
Credentials:ASCW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1752 ELWOOD ST
Mailing Address - Street 2:
Mailing Address - City:POMONA
Mailing Address - State:CA
Mailing Address - Zip Code:91768-1208
Mailing Address - Country:US
Mailing Address - Phone:909-436-6592
Mailing Address - Fax:
Practice Address - Street 1:601 5TH AVE
Practice Address - Street 2:
Practice Address - City:UPLAND
Practice Address - State:CA
Practice Address - Zip Code:91786-4839
Practice Address - Country:US
Practice Address - Phone:909-949-6526
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-02
Last Update Date:2024-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA90383104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker