Most Relevant Information
Provider Data
NPI Number: | 1003539685 |
Provider Name: | KIMBERLY LUCAS |
Entity Type: | Individual |
Taxonomy Code: | 106S00000X |
Specialty: | Behavior Technician |
License Number: |
Most Important Dates
Enumeration Date: | 09/20/2022 |
Last Updated: | 09/20/2022 |
Provider Practice Location
1101 S WINCHESTER BLVD # B-1101
SAN JOSE
CA
951283901
Practice Location Phone/Fax
Phone: | 4084841028 |
Fax: |
Provider Mailing Location
1101 S WINCHESTER BLVD # B-1101
SAN JOSE
CA
951283901
Provider Mailing Phone/Fax
Phone: | 4084841028 |
Fax: |