Provider Demographics
NPI:1891945218
Name:LOWER, LUANN
Entity Type:Individual
Prefix:
First Name:LUANN
Middle Name:
Last Name:LOWER
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 1:12307 RAGWEED ST
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92129-4108
Mailing Address - Country:US
Mailing Address - Phone:619-733-7632
Mailing Address - Fax:619-733-7632
Practice Address - Street 1:6540 LUSK BLVD
Practice Address - Street 2:SUITE C239
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92121-2767
Practice Address - Country:US
Practice Address - Phone:619-733-7632
Practice Address - Fax:619-733-7632
Is Sole Proprietor?:No
Enumeration Date:2008-09-22
Last Update Date:2012-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPQ9521OtherSAN DIEGO REGIONAL CENTER VENDOR #