Provider Demographics
NPI:1316006265
Name:FURUTA, LUCIA PAULA
Entity Type:Individual
Prefix:MS
First Name:LUCIA
Middle Name:PAULA
Last Name:FURUTA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LUCIA
Other - Middle Name:LANZADERAS
Other - Last Name:FURUTA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSW
Mailing Address - Street 1:419 WILLAPA LANE
Mailing Address - Street 2:
Mailing Address - City:DIAMOND BAR
Mailing Address - State:CA
Mailing Address - Zip Code:91765
Mailing Address - Country:US
Mailing Address - Phone:714-930-6141
Mailing Address - Fax:
Practice Address - Street 1:1925 N. DALY ST.
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90031
Practice Address - Country:US
Practice Address - Phone:323-226-4800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS 160711041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical