Provider Demographics
NPI:1992831549
Name:DUVENARY, S'CANDA R (LCSW)
Entity Type:Individual
Prefix:
First Name:S'CANDA
Middle Name:R
Last Name:DUVENARY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 40992
Mailing Address - Street 2:
Mailing Address - City:DOWNEY
Mailing Address - State:CA
Mailing Address - Zip Code:90239-1992
Mailing Address - Country:US
Mailing Address - Phone:310-890-6371
Mailing Address - Fax:562-776-8965
Practice Address - Street 1:9357 GUATEMALA AVE
Practice Address - Street 2:
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90240-2021
Practice Address - Country:US
Practice Address - Phone:310-890-6371
Practice Address - Fax:562-776-8965
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS21822101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional