Provider Demographics
NPI:1003986902
Name:DURBY, DENNIS DION (MSW)
Entity Type:Individual
Prefix:MR
First Name:DENNIS
Middle Name:DION
Last Name:DURBY
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:524 W COMMONWEALTH AVE
Mailing Address - Street 2:SUITE K
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92832-1764
Mailing Address - Country:US
Mailing Address - Phone:714-209-7595
Mailing Address - Fax:
Practice Address - Street 1:524 W COMMONWEALTH AVE
Practice Address - Street 2:SUITE K
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92832-1764
Practice Address - Country:US
Practice Address - Phone:714-680-0241
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS151671041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical