Provider Demographics
NPI:1013459205
Name:DUGINSKI, NEILE
Entity type:Individual
Prefix:
First Name:NEILE
Middle Name:
Last Name:DUGINSKI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 HARVEY DR APT 216
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94597-3602
Mailing Address - Country:US
Mailing Address - Phone:760-445-1258
Mailing Address - Fax:
Practice Address - Street 1:1350 ARNOLD DR STE 102
Practice Address - Street 2:
Practice Address - City:MARTINEZ
Practice Address - State:CA
Practice Address - Zip Code:94553-4190
Practice Address - Country:US
Practice Address - Phone:925-266-6961
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-06
Last Update Date:2021-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAASW 71034101YM0800X
CA932531041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health