Provider Demographics
NPI:1700083672
Name:LUCAS, PATRICE LORENA (PHARMD)
Entity Type:Individual
Prefix:MS
First Name:PATRICE
Middle Name:LORENA
Last Name:LUCAS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5032 CAPISTRANO AVE
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95129-1024
Mailing Address - Country:US
Mailing Address - Phone:408-533-5721
Mailing Address - Fax:
Practice Address - Street 1:275 HOSPITAL PKWY STE 625
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95119-1141
Practice Address - Country:US
Practice Address - Phone:408-363-4856
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-02
Last Update Date:2021-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY013662183500000X
CA683351835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy
No183500000XPharmacy Service ProvidersPharmacist