Theres Luckose

NPI 1255675781 - Social Worker - 104100000X

NPI Details
NPI 1255675781
Gender Female
Enumeration Date 11/21/2012
Last Updated 11/21/2012
Entity Type Individual
Active Over 4 years ago
Practice Location
1 MAIN ST
SAN QUENTIN CA, 94964-1000, US
Phone (415) 454-1460
Fax
Business Location
37359 CHINABERRY CMN
FREMONT CA, 94536-7924, US
Phone (510) 796-1523
Fax
Toxanomy
Taxonomy Code 104100000X
License State
License Number
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According to our database, Ms. Theres Luckose NPI is 1255675781, taxonomy code is 104100000X Theres Luckose physically located at 1 Main St, San Quentin CA, 94964-1000. NPI Number Theres Luckose has the Individual type.

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1255675781 NPI number is provided on an as is basis without warranty of any kind. 1255675781 is maintained by the National Plan & Provider Enumeration System. The contents of Theres Luckose are for informational purposes only.