Provider Demographics
NPI:1972855252
Name:LUCAS, ALISON BANET
Entity Type:Individual
Prefix:
First Name:ALISON
Middle Name:BANET
Last Name:LUCAS
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 1:2325 ROOSEVELT AVE
Mailing Address - Street 2:APT. #2
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94703-1723
Mailing Address - Country:US
Mailing Address - Phone:812-340-1521
Mailing Address - Fax:
Practice Address - Street 1:2500 18TH ST
Practice Address - Street 2:HOMELESS PRENATAL PROGRAMS
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110-2109
Practice Address - Country:US
Practice Address - Phone:415-546-6756
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-10
Last Update Date:2015-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No104100000XBehavioral Health & Social Service ProvidersSocial Worker