Basic Information
| Provider Information | |||||||||
| NPI: | 1174710412 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DUHE | ||||||||
| FirstName: | REGINALD | ||||||||
| MiddleName: | VINCENT | ||||||||
| NamePrefix: | MR. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1425 MURCHISON DR | ||||||||
| Address2: | |||||||||
| City: | MILLBRAE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 940302854 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6506529450 | ||||||||
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| Practice Location | |||||||||
| Address1: | 400 EDMONDS RD | ||||||||
| Address2: | |||||||||
| City: | REDWOOD CITY | ||||||||
| State: | CA | ||||||||
| PostalCode: | 940623803 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6508391810 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/01/2007 | ||||||||
| LastUpdateDate: | 10/01/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.