Provider Demographics
NPI:1275915159
Name:LUGO, DANIEL C (CATCI)
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:C
Last Name:LUGO
Suffix:
Gender:M
Credentials:CATCI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7737 HELLMAN AVENUE
Mailing Address - Street 2:12
Mailing Address - City:ROSEMEAD
Mailing Address - State:CA
Mailing Address - Zip Code:91770-7113
Mailing Address - Country:US
Mailing Address - Phone:626-639-7747
Mailing Address - Fax:
Practice Address - Street 1:7737 HELLMAN AVE
Practice Address - Street 2:APT 12
Practice Address - City:ROSEMEAD
Practice Address - State:CA
Practice Address - Zip Code:91770-2349
Practice Address - Country:US
Practice Address - Phone:626-639-7747
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-26
Last Update Date:2020-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA168508 I101YA0400X
CAAII056530518101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)