Provider Demographics
NPI:1396507455
Name:DUENAS, MARGARET ANN (CADCIII)
Entity type:Individual
Prefix:
First Name:MARGARET
Middle Name:ANN
Last Name:DUENAS
Suffix:
Gender:F
Credentials:CADCIII
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22661 PALM AVE UNIT D
Mailing Address - Street 2:
Mailing Address - City:GRAND TERRACE
Mailing Address - State:CA
Mailing Address - Zip Code:92313-5260
Mailing Address - Country:US
Mailing Address - Phone:909-222-7575
Mailing Address - Fax:
Practice Address - Street 1:4954 ARLINGTON AVE STE A
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92504-2746
Practice Address - Country:US
Practice Address - Phone:909-222-7575
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-24
Last Update Date:2024-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CABII00770424101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)