Mr Jorge A Duque, is a
Social Worker - Clinical based in Santa Cruz, California. Mr Jorge A Duque is licensed to practice in California (license number 65726) and his current practice location is
1080 Emeline Ave, Santa Cruz, California. He can be reached at his office (for appointments etc.) via phone at
(831) 454-4100.
NPI number for Mr Jorge A Duque is 1962671800 and his current mailing address is Po Box 962, Santa Cruz, California. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1962671800.
Healthcare Provider's Profile
| Full Name | Mr Jorge A Duque |
|---|
| Gender | Male |
|---|
| Speciality | Social Worker - Clinical |
|---|
| Location | 1080 Emeline Ave, Santa Cruz, California |
|---|
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
|---|
NPI Data:
- NPI Number: 1962671800
- Provider Enumeration Date: 02/25/2008
- Last Update Date: 05/11/2017
Medical Identifiers
Medical identifiers for Mr Jorge A Duque such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1962671800 | NPI | - | NPPES |
| ZZZ91892Z | Other | CA | MEDICARE SITE GROUP PTAN# SANTA CRUZ COUNTY CA |
| ZZZ92069Z | Other | CA | MEDICARE SITE GROUP PTAN# SANTA CRUZ COUNTY CA |
| ZZZ91891Z | Other | CA | MEDICARE SITE GROUP PTAN# SANTA CRUZ COUNTY CA |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 1041C0700X | Social Worker - Clinical | 65726 (California) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Jorge A Duque is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Mr Jorge A Duque,
Po Box 962,
Santa Cruz, CA 95061-0962
Ph: (831) 454-4170 | Mr Jorge A Duque,
1080 Emeline Ave,
Santa Cruz, CA 95060-1966
Ph: (831) 454-4100 |
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