Provider Demographics
NPI:1255649430
Name:DURAN, GEORGINA V (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:GEORGINA
Middle Name:V
Last Name:DURAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MRS
Other - First Name:GINA
Other - Middle Name:V
Other - Last Name:DURAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:1965 LIVE OAK BLVD
Mailing Address - Street 2:
Mailing Address - City:YUBA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:95991-8850
Mailing Address - Country:US
Mailing Address - Phone:530-822-7200
Mailing Address - Fax:
Practice Address - Street 1:1965 LIVE OAK BLVD
Practice Address - Street 2:
Practice Address - City:YUBA CITY
Practice Address - State:CA
Practice Address - Zip Code:95991-8850
Practice Address - Country:US
Practice Address - Phone:530-822-7200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-21
Last Update Date:2021-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X, 104100000X
CA939321041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No104100000XBehavioral Health & Social Service ProvidersSocial Worker