Active NPI
Carolyn Duong
- Physician Assistant
- Modesto, CA
National Provider Identifier
1346022167
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA68614
- Practice address
- 1401 Spanos CT Ste 121
Modesto, CA 95355-2812 - Phone
- (209) 550-4779
- NPI assigned
- Oct 17, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA68614 | CA | Primary |
Addresses
Primary practice location
1401 Spanos CT Ste 121
Modesto, CA 95355-2812
Mailing address
PO Box 255228
Sacramento, CA 95865-5228
Other practice location 1
1310 Club Dr
Vallejo, CA 94592-1187
Phone (707) 638-5809
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1697500800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1788912000000",
"number": "1346022167",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 255228",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958655228"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1401 SPANOS CT STE 121",
"city": "MODESTO",
"state": "CA",
"postal_code": "953552812",
"telephone_number": "209-550-4779"
}
],
"practiceLocations": [
{
"address_1": "1310 Club Dr",
"address_purpose": "LOCATION",
"city": "Vallejo",
"state": "CA",
"postal_code": "945921187",
"country_code": "US",
"telephone_number": "707-638-5809",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DUONG",
"first_name": "CAROLYN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-10-17",
"last_updated": "2026-09-09",
"certification_date": "2026-09-09",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Physician Assistant",
"state": "CA",
"license": "PA68614",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Modesto, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.