Provider Demographics
NPI:1033228846
Name:DUNIPACE, VIVIAN DUNCAN (LCSW)
Entity Type:Individual
Prefix:
First Name:VIVIAN
Middle Name:DUNCAN
Last Name:DUNIPACE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3086 W RAMSEY ST
Mailing Address - Street 2:
Mailing Address - City:BANNING
Mailing Address - State:CA
Mailing Address - Zip Code:92220-3724
Mailing Address - Country:US
Mailing Address - Phone:951-922-9094
Mailing Address - Fax:951-922-9598
Practice Address - Street 1:3086 W RAMSEY ST
Practice Address - Street 2:
Practice Address - City:BANNING
Practice Address - State:CA
Practice Address - Zip Code:92220-3724
Practice Address - Country:US
Practice Address - Phone:951-922-9094
Practice Address - Fax:951-922-9598
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS118851041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical