Provider Demographics
NPI:1245591254
Name:LUCAS, CASSIEOPIA NORMA-NICOLE
Entity Type:Individual
Prefix:
First Name:CASSIEOPIA
Middle Name:NORMA-NICOLE
Last Name:LUCAS
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 1:28546 SUNRIDGE CT
Mailing Address - Street 2:
Mailing Address - City:MENIFEE
Mailing Address - State:CA
Mailing Address - Zip Code:92584-7421
Mailing Address - Country:US
Mailing Address - Phone:951-809-3424
Mailing Address - Fax:
Practice Address - Street 1:3801 UNIVERSITY AVE
Practice Address - Street 2:SUITE 400
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92501-3247
Practice Address - Country:US
Practice Address - Phone:951-955-7108
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-06
Last Update Date:2012-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist