Enrique Madrid Duran, MFT PRE-LICENSED

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

IMF62572 Issued in CA

Practice address

934 N. Mountain Ave, Suite C.
Upland, CA 91786

Phone

(909) 458-1350

Fax

(909) 579-8149

NPI assigned

Jul 28, 2009

Last updated

Dec 4, 2013By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1248739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386115200000",
    "number": "1225269004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "934 N. MOUNTAIN AVE, SUITE C.",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "91786",
            "telephone_number": "909-458-1350",
            "fax_number": "909-579-8149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "934 N. MOUNTAIN AVE, SUITE C.",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "91786",
            "telephone_number": "909-458-1350",
            "fax_number": "909-579-8149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DURAN",
        "first_name": "ENRIQUE",
        "middle_name": "MADRID",
        "name_prefix": "Mr.",
        "credential": "MFT PRE-LICENSED",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-28",
        "last_updated": "2013-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "IMF62572",
            "primary": true
        },
        {
            "code": "225C00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Counselor",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Roger Dennis Duber, DO
• Donna E Dudziak, M.D.
• Dulce R de Castro M D a Professional Corporation
• Tanya Elizabeth Dumas
• Myesha Nicole Dunn, M.A.
• Danella Durango-Perez
• Kennedy Teresa Durant
• Roman Duro
• Nancy Guadalupe Duron, ASCW
• Daniel Duroseau, DDS

• Marriage & Family Therapist in Upland, CA
• Providers in Upland, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.