Provider Demographics
NPI:1730661430
Name:PEYGHAMBARY, DEANNA DURAN
Entity type:Individual
Prefix:
First Name:DEANNA
Middle Name:DURAN
Last Name:PEYGHAMBARY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:DEANNA
Other - Middle Name:DURAN
Other - Last Name:RODRIGUEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 27033
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93729-7033
Mailing Address - Country:US
Mailing Address - Phone:559-991-5592
Mailing Address - Fax:
Practice Address - Street 1:6051 N FRESNO ST STE 103
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93710-5280
Practice Address - Country:US
Practice Address - Phone:559-226-2273
Practice Address - Fax:559-226-2273
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-30
Last Update Date:2025-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA114153106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist