Provider Demographics
NPI:1457902439
Name:DUARTE, GEORGE EUGENE (MS, LMFT)
Entity Type:Individual
Prefix:
First Name:GEORGE
Middle Name:EUGENE
Last Name:DUARTE
Suffix:
Gender:M
Credentials:MS, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2739 CASTLE ROCK RD
Mailing Address - Street 2:
Mailing Address - City:DIAMOND BAR
Mailing Address - State:CA
Mailing Address - Zip Code:91765-3519
Mailing Address - Country:US
Mailing Address - Phone:909-240-4431
Mailing Address - Fax:
Practice Address - Street 1:425 W BONITA AVE STE 103
Practice Address - Street 2:
Practice Address - City:SAN DIMAS
Practice Address - State:CA
Practice Address - Zip Code:91773-2543
Practice Address - Country:US
Practice Address - Phone:909-240-4431
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-22
Last Update Date:2019-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist