Provider Demographics
NPI:1265270508
Name:MAUSOLFF, LUCERO MARIA
Entity type:Individual
Prefix:
First Name:LUCERO
Middle Name:MARIA
Last Name:MAUSOLFF
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 1:2971 SANDI DR
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95973-0442
Mailing Address - Country:US
Mailing Address - Phone:530-204-7604
Mailing Address - Fax:
Practice Address - Street 1:OROVILLE WELLNESS AND RECOVERY CENTER
Practice Address - Street 2:82 TABLE MOUNTAIN BOULEVARD
Practice Address - City:OROVILLE
Practice Address - State:CA
Practice Address - Zip Code:95965
Practice Address - Country:US
Practice Address - Phone:530-538-2574
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-19
Last Update Date:2024-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist