Provider Demographics
NPI:1437596277
Name:LUKAS, ALISSA MARIE (MA)
Entity Type:Individual
Prefix:
First Name:ALISSA
Middle Name:MARIE
Last Name:LUKAS
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1449 MUNOZ PL
Mailing Address - Street 2:
Mailing Address - City:PLACENTIA
Mailing Address - State:CA
Mailing Address - Zip Code:92870-7202
Mailing Address - Country:US
Mailing Address - Phone:714-746-6424
Mailing Address - Fax:
Practice Address - Street 1:4281 KATELLA AVE STE 201
Practice Address - Street 2:
Practice Address - City:LOS ALAMITOS
Practice Address - State:CA
Practice Address - Zip Code:90720-6509
Practice Address - Country:US
Practice Address - Phone:562-467-5536
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-03
Last Update Date:2013-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health