Provider Demographics
NPI:1578267134
Name:VO, DUC PETER
Entity Type:Individual
Prefix:
First Name:DUC PETER
Middle Name:
Last Name:VO
Suffix:
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 1:11602 ALLWOOD DR
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92503-0802
Mailing Address - Country:US
Mailing Address - Phone:951-410-5763
Mailing Address - Fax:
Practice Address - Street 1:136 E 6TH ST
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:CA
Practice Address - Zip Code:92223-2146
Practice Address - Country:US
Practice Address - Phone:951-845-3588
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-28
Last Update Date:2023-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist