Provider Demographics
NPI:1700637154
Name:LUCERO WELLBEING
Entity Type:Organization
Organization Name:LUCERO WELLBEING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:LUZ
Authorized Official - Middle Name:ALEHIDA
Authorized Official - Last Name:ROBLES
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:213-259-3404
Mailing Address - Street 1:10161 PARK RUN DR STE 150
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89145-8872
Mailing Address - Country:US
Mailing Address - Phone:213-259-3404
Mailing Address - Fax:
Practice Address - Street 1:10161 PARK RUN DR STE 150
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89145-8872
Practice Address - Country:US
Practice Address - Phone:213-259-3404
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-01
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health