Theres Luckose Valid NPI
Individual provider · Clinical Social Worker · San Quentin, CA
- NPI
- 1255675781
- Type
- Individual (Type 1)
- Primary specialty
- Clinical Social Worker (Social Worker)
- Specialty group
- Behavioral Health & Social Service Providers
- Taxonomy code
- 1041C0700X
- License number
- 75515 (CA)
- Sex
- Female
- Sole proprietor
- No
- Enumerated
- 2012-11-21
- Last updated
- 2023-01-10
Practice location
1 Main St
San Quentin, CA 94964-1000
(415) 454-1460