Provider Demographics
NPI:1902932254
Name:PENA-DUGGAN, YOLANDA DIANA (MFTI)
Entity Type:Individual
Prefix:MRS
First Name:YOLANDA
Middle Name:DIANA
Last Name:PENA-DUGGAN
Suffix:
Gender:F
Credentials:MFTI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5420 N FIGUEROA ST
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND PARK
Mailing Address - State:CA
Mailing Address - Zip Code:90042-4118
Mailing Address - Country:US
Mailing Address - Phone:323-999-2404
Mailing Address - Fax:
Practice Address - Street 1:5420 N FIGUEROA ST
Practice Address - Street 2:
Practice Address - City:HIGHLAND PARK
Practice Address - State:CA
Practice Address - Zip Code:90042-4118
Practice Address - Country:US
Practice Address - Phone:323-999-2404
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA51946106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist