Doctor Name: | MRS. LESLIE KATHRYN LUCAS |
NPI Number: | 1033375050 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | |
Business Practice Address: | 2791 Green River Rd Ste 101 Corona, CA - 928827452 |
Business Phone Number: | 9512793222 |
Business Fax Number: | 9512795222 |
Mailing Address: | 2791 Green River Rd Ste 101, CORONA |
State: | CA |
Postal Code: | 928827452 |
Phone Number: | 9512793222 |
Fax Number: | 9512795222 |
NPI Enumeration Date: | 07/29/2008 |
NPI Last Update Date: | 07/29/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |