Provider Demographics
NPI:1659577872
Name:CHISZAR, LUCINDA MICHELLE (LM)
Entity Type:Individual
Prefix:MS
First Name:LUCINDA
Middle Name:MICHELLE
Last Name:CHISZAR
Suffix:
Gender:F
Credentials:LM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:128 SPENCER AVE
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95351-2614
Mailing Address - Country:US
Mailing Address - Phone:209-521-7981
Mailing Address - Fax:209-521-7981
Practice Address - Street 1:128 SPENCER AVE
Practice Address - Street 2:
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95351-2614
Practice Address - Country:US
Practice Address - Phone:209-521-7981
Practice Address - Fax:209-521-7981
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-25
Last Update Date:2013-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA90176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife