Provider Demographics
NPI:1952176281
Name:DUARTE, IRIS JAN (MSW, LCSW 13225)
Entity Type:Individual
Prefix:
First Name:IRIS
Middle Name:JAN
Last Name:DUARTE
Suffix:
Gender:F
Credentials:MSW, LCSW 13225
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:374 MCKELVY AVE
Mailing Address - Street 2:
Mailing Address - City:CLOVIS
Mailing Address - State:CA
Mailing Address - Zip Code:93611-5413
Mailing Address - Country:US
Mailing Address - Phone:559-392-4701
Mailing Address - Fax:
Practice Address - Street 1:374 MCKELVY AVE
Practice Address - Street 2:
Practice Address - City:CLOVIS
Practice Address - State:CA
Practice Address - Zip Code:93611-5413
Practice Address - Country:US
Practice Address - Phone:559-392-4701
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-16
Last Update Date:2023-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA132251041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical