Individual
JON MICHAEL LAZALETA DUEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2105 MARTIN LUTHER KING JR WAY FL 1, BERKELEY, CA 94704-1108
(888) 588-8995
(510) 756-0812
Mailing address
2105 MARTIN LUTHER KING JR WAY FL 1, BERKELEY, CA 94704-1108
(888) 588-8995
(510) 756-0812
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
163W00000X
Registered Nurse
658352-1
NY
163W00000X
Registered Nurse
95035248
CA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
95001898
CA
Other
Enumeration date
07/18/2008
Last updated
04/17/2025
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