Provider Demographics
NPI:1043559933
Name:HALBASCH, LUCY (RDHAP)
Entity type:Individual
Prefix:MRS
First Name:LUCY
Middle Name:
Last Name:HALBASCH
Suffix:
Gender:F
Credentials:RDHAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13646 KALNOR AVE
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:CA
Mailing Address - Zip Code:90650-4022
Mailing Address - Country:US
Mailing Address - Phone:562-644-8884
Mailing Address - Fax:
Practice Address - Street 1:13646 KALNOR AVE
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:CA
Practice Address - Zip Code:90650-4022
Practice Address - Country:US
Practice Address - Phone:562-644-8884
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-12
Last Update Date:2013-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAHAP441124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist