Provider Demographics
NPI:1114235660
Name:MEYER, LUCERO A
Entity Type:Individual
Prefix:
First Name:LUCERO
Middle Name:A
Last Name:MEYER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4275 EL CAJON BLVD
Mailing Address - Street 2:101
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92105-1293
Mailing Address - Country:US
Mailing Address - Phone:619-283-9624
Mailing Address - Fax:619-641-7656
Practice Address - Street 1:4275 EL CAJON BLVD
Practice Address - Street 2:101
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92105-1293
Practice Address - Country:US
Practice Address - Phone:619-283-9624
Practice Address - Fax:619-641-7656
Is Sole Proprietor?:No
Enumeration Date:2010-09-17
Last Update Date:2010-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor