Provider Demographics
NPI:1881969087
Name:DUQUE, YOLANDA (OTR/L)
Entity type:Individual
Prefix:MS
First Name:YOLANDA
Middle Name:
Last Name:DUQUE
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:156 CASUDA CANYON DR
Mailing Address - Street 2:
Mailing Address - City:MONTEREY PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91754-2235
Mailing Address - Country:US
Mailing Address - Phone:626-300-5854
Mailing Address - Fax:
Practice Address - Street 1:330 GOLDEN SHR
Practice Address - Street 2:SUITE 250
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90802-4246
Practice Address - Country:US
Practice Address - Phone:562-256-7540
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-20
Last Update Date:2012-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA925174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist