Provider Demographics
NPI:1770892952
Name:PLUMB, N LUCAS (PHD)
Entity type:Individual
Prefix:DR
First Name:N
Middle Name:LUCAS
Last Name:PLUMB
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:MS
Other - First Name:NANCY
Other - Middle Name:LUCAS
Other - Last Name:ROBERTSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1010 5TH ST
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95404-4307
Mailing Address - Country:US
Mailing Address - Phone:707-529-3030
Mailing Address - Fax:707-546-1010
Practice Address - Street 1:1008 5TH ST
Practice Address - Street 2:
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95404-4307
Practice Address - Country:US
Practice Address - Phone:707-529-3030
Practice Address - Fax:707-546-1010
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-05
Last Update Date:2023-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSB34897101Y00000X
CAPSY24405103T00000X, 103TB0200X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral