Provider Demographics
NPI:1972363299
Name:DUNCAN, TREVOR G
Entity Type:Individual
Prefix:DR
First Name:TREVOR
Middle Name:G
Last Name:DUNCAN
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 1:162 E CARSON ST
Mailing Address - Street 2:
Mailing Address - City:COLUSA
Mailing Address - State:CA
Mailing Address - Zip Code:95932-2880
Mailing Address - Country:US
Mailing Address - Phone:530-458-0388
Mailing Address - Fax:530-458-7751
Practice Address - Street 1:162 E CARSON ST
Practice Address - Street 2:
Practice Address - City:COLUSA
Practice Address - State:CA
Practice Address - Zip Code:95932-2880
Practice Address - Country:US
Practice Address - Phone:530-458-0388
Practice Address - Fax:530-458-7751
Is Sole Proprietor?:No
Enumeration Date:2024-03-21
Last Update Date:2024-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSB94027439101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health