Provider Demographics
NPI:1093872921
Name:AYERS, DUJUAN ANDRE II
Entity Type:Individual
Prefix:MR
First Name:DUJUAN
Middle Name:ANDRE
Last Name:AYERS
Suffix:II
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4498 N CORNELIA AVE APT 241
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93722-3854
Mailing Address - Country:US
Mailing Address - Phone:559-577-5336
Mailing Address - Fax:
Practice Address - Street 1:4498 N CORNELIA AVE APT 241
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93722-3854
Practice Address - Country:US
Practice Address - Phone:559-577-5336
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health