Provider Demographics
NPI:1093200016
Name:LUCATERO, ALEJANDRA (MSW)
Entity Type:Individual
Prefix:
First Name:ALEJANDRA
Middle Name:
Last Name:LUCATERO
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:351 E ROSSELLEN PL APT 12
Mailing Address - Street 2:
Mailing Address - City:COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91723-3544
Mailing Address - Country:US
Mailing Address - Phone:626-422-8409
Mailing Address - Fax:
Practice Address - Street 1:1111 LUNALILO ST # 235292
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96822-3956
Practice Address - Country:US
Practice Address - Phone:773-888-3312
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-22
Last Update Date:2022-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X, 225400000X, 225C00000X
HI4841101YM0800X
CA89237101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner
No225C00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Counselor