Provider Demographics
NPI:1720776859
Name:BELTRAN, LUCERO (PCC)
Entity Type:Individual
Prefix:
First Name:LUCERO
Middle Name:
Last Name:BELTRAN
Suffix:
Gender:F
Credentials:PCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18527 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LINDEN
Mailing Address - State:CA
Mailing Address - Zip Code:95236-9584
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:18527 MAIN ST
Practice Address - Street 2:
Practice Address - City:LINDEN
Practice Address - State:CA
Practice Address - Zip Code:95236-9584
Practice Address - Country:US
Practice Address - Phone:209-887-3894
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-26
Last Update Date:2023-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool