Provider Demographics
NPI:1437298932
Name:MASSEY, LUCY RHU
Entity Type:Individual
Prefix:MS
First Name:LUCY
Middle Name:RHU
Last Name:MASSEY
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 1:2023 VALE ROAD SUITE 107
Mailing Address - Street 2:BROOKSIDE COMMUNITY HEALTH CENTER
Mailing Address - City:SAN PABLO
Mailing Address - State:CA
Mailing Address - Zip Code:94806-3834
Mailing Address - Country:US
Mailing Address - Phone:510-231-9800
Mailing Address - Fax:510-412-9867
Practice Address - Street 1:2023 VALE ROAD SUITE 107
Practice Address - Street 2:BROOKSIDE COMMUNITY HEALTH CENTER
Practice Address - City:SAN PABLO
Practice Address - State:CA
Practice Address - Zip Code:94806-3834
Practice Address - Country:US
Practice Address - Phone:510-231-9800
Practice Address - Fax:510-412-9867
Is Sole Proprietor?:No
Enumeration Date:2007-02-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
E32511Medicare UPIN