Provider Demographics
NPI:1013558212
Name:DUARTE, KATHERINE XIOMARA
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:XIOMARA
Last Name:DUARTE
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 1:624 COMMERCE AVE
Mailing Address - Street 2:
Mailing Address - City:PALMDALE
Mailing Address - State:CA
Mailing Address - Zip Code:93551-3883
Mailing Address - Country:US
Mailing Address - Phone:661-942-9135
Mailing Address - Fax:
Practice Address - Street 1:624 COMMERCE AVE
Practice Address - Street 2:
Practice Address - City:PALMDALE
Practice Address - State:CA
Practice Address - Zip Code:93551-3883
Practice Address - Country:US
Practice Address - Phone:661-942-9135
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-30
Last Update Date:2022-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No171M00000XOther Service ProvidersCase Manager/Care Coordinator