Provider Demographics
NPI:1720356959
Name:DUCLOS, MARGEAUX OLIVIA (LMFT)
Entity Type:Individual
Prefix:
First Name:MARGEAUX
Middle Name:OLIVIA
Last Name:DUCLOS
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1420 E LOS ANGELES AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:SIMI VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93065-7812
Mailing Address - Country:US
Mailing Address - Phone:814-335-2032
Mailing Address - Fax:
Practice Address - Street 1:1420 E LOS ANGELES AVE STE 201
Practice Address - Street 2:
Practice Address - City:SIMI VALLEY
Practice Address - State:CA
Practice Address - Zip Code:93065-7812
Practice Address - Country:US
Practice Address - Phone:814-335-2032
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-02
Last Update Date:2023-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA135960106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty