Provider Demographics
NPI:1457841165
Name:DUENAS, STEVEN ALBERT (PT/DPT/CSCS)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:ALBERT
Last Name:DUENAS
Suffix:
Gender:M
Credentials:PT/DPT/CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6540 AMBROSIA LN
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92011-2613
Mailing Address - Country:US
Mailing Address - Phone:425-214-6167
Mailing Address - Fax:
Practice Address - Street 1:215 S HICKORY ST STE 112
Practice Address - Street 2:
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92025
Practice Address - Country:US
Practice Address - Phone:760-737-8460
Practice Address - Fax:760-739-5669
Is Sole Proprietor?:No
Enumeration Date:2018-05-17
Last Update Date:2018-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA294820225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist