Basic Information
Provider Information
NPI: 1497210876
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DUNCAN
FirstName: NICOLE
MiddleName: FRANCES
NamePrefix:  
NameSuffix:  
Credential: M.A.,CCC-SLP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 9300 VALLEY CHILDRENS PL
Address2:  
City: MADERA
State: CA
PostalCode: 936368761
CountryCode: US
TelephoneNumber: 5593533000
FaxNumber:  
Practice Location
Address1: 9300 VALLEY CHILDRENS PL
Address2:  
City: MADERA
State: CA
PostalCode: 936368761
CountryCode: US
TelephoneNumber: 5593533000
FaxNumber:  
Other Information
ProviderEnumerationDate: 02/09/2019
LastUpdateDate: 02/09/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
235Z00000X16625CAY Speech, Language and Hearing Service ProvidersSpeech-Language Pathologist 

No ID Information.


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