Provider Demographics
NPI:1417072000
Name:NELSON, LUCIA
Entity Type:Individual
Prefix:MRS
First Name:LUCIA
Middle Name:
Last Name:NELSON
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 1:1755 W HAMMER LN STE 8
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95209-2900
Mailing Address - Country:US
Mailing Address - Phone:209-444-8910
Mailing Address - Fax:209-444-8905
Practice Address - Street 1:1755 W HAMMER LN STE 8
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95209-2900
Practice Address - Country:US
Practice Address - Phone:209-444-8910
Practice Address - Fax:209-444-8905
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2012-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker