Provider Demographics
NPI:1720581648
Name:LUCERO, JOSEPHINE ANNE CO (PCT)
Entity Type:Individual
Prefix:MRS
First Name:JOSEPHINE ANNE
Middle Name:CO
Last Name:LUCERO
Suffix:
Gender:F
Credentials:PCT
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:15630 ASHGROVE DR
Mailing Address - Street 2:
Mailing Address - City:LA MIRADA
Mailing Address - State:CA
Mailing Address - Zip Code:90638-4906
Mailing Address - Country:US
Mailing Address - Phone:714-928-7989
Mailing Address - Fax:714-266-0021
Practice Address - Street 1:5600 RICKENBACKER RD BLDG 2A
Practice Address - Street 2:
Practice Address - City:BELL
Practice Address - State:CA
Practice Address - Zip Code:90201-6425
Practice Address - Country:US
Practice Address - Phone:323-263-1206
Practice Address - Fax:323-263-8543
Is Sole Proprietor?:No
Enumeration Date:2018-03-16
Last Update Date:2018-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor