Individual
MABEL ALICIA DUERKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LEP
Contact information
Practice address
42586 BRADSHAW DR, TEMECULA, CA 92592-6639
(619) 632-7079
Mailing address
42586 BRADSHAW DR, TEMECULA, CA 92592-6639
(619) 632-7079
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
4000
CA
103TM1800X
Intellectual & Developmental Disabilities Psychologist
4000
CA
103TS0200X
School Psychologist
4000
CA
Other
Enumeration date
03/29/2023
Last updated
03/29/2023
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