Provider Demographics
NPI:1508184169
Name:AUGUST, LUCIA (MA)
Entity Type:Individual
Prefix:MS
First Name:LUCIA
Middle Name:
Last Name:AUGUST
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 1:20200 REDWOOD RD
Mailing Address - Street 2:SUITE 8
Mailing Address - City:CASTRO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94546-4313
Mailing Address - Country:US
Mailing Address - Phone:510-792-5588
Mailing Address - Fax:800-813-7804
Practice Address - Street 1:20200 REDWOOD RD
Practice Address - Street 2:SUITE 8
Practice Address - City:CASTRO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:94546-4313
Practice Address - Country:US
Practice Address - Phone:510-792-5588
Practice Address - Fax:800-813-7804
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-06
Last Update Date:2010-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC27658106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist