Provider Demographics
NPI:1760266381
Name:LUCA, CATALINA
Entity Type:Individual
Prefix:
First Name:CATALINA
Middle Name:
Last Name:LUCA
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 1:6530 E STRATFORD DR
Mailing Address - Street 2:
Mailing Address - City:PRESCOTT VLY
Mailing Address - State:AZ
Mailing Address - Zip Code:86314-3825
Mailing Address - Country:US
Mailing Address - Phone:928-775-2409
Mailing Address - Fax:928-775-2409
Practice Address - Street 1:6530 E STRATFORD DR
Practice Address - Street 2:
Practice Address - City:PRESCOTT VLY
Practice Address - State:AZ
Practice Address - Zip Code:86314-3825
Practice Address - Country:US
Practice Address - Phone:928-775-2409
Practice Address - Fax:928-775-2409
Is Sole Proprietor?:No
Enumeration Date:2023-08-23
Last Update Date:2023-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAL6884H376G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376G00000XNursing Service Related ProvidersNursing Home Administrator