Provider Demographics
NPI:1922108570
Name:LUCCHETTI, FRANK JOSEPH (EDD)
Entity Type:Individual
Prefix:DR
First Name:FRANK
Middle Name:JOSEPH
Last Name:LUCCHETTI
Suffix:
Gender:M
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:181 ANDRIEUX ST
Mailing Address - Street 2:#204
Mailing Address - City:SONOMA
Mailing Address - State:CA
Mailing Address - Zip Code:95476-6932
Mailing Address - Country:US
Mailing Address - Phone:707-938-1030
Mailing Address - Fax:707-938-1900
Practice Address - Street 1:181 ANDRIEUX ST
Practice Address - Street 2:#204
Practice Address - City:SONOMA
Practice Address - State:CA
Practice Address - Zip Code:95476-6932
Practice Address - Country:US
Practice Address - Phone:707-938-1030
Practice Address - Fax:707-938-1900
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY13732103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAOPL137320Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER