Provider Demographics
NPI:1447449202
Name:LUCAS, MONICA KAWEKIU (HHP)
Entity type:Individual
Prefix:MRS
First Name:MONICA
Middle Name:KAWEKIU
Last Name:LUCAS
Suffix:
Gender:F
Credentials:HHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16769 BERNARDO CENTER DR STE K13
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92128-2546
Mailing Address - Country:US
Mailing Address - Phone:858-673-1244
Mailing Address - Fax:858-673-1246
Practice Address - Street 1:16769 BERNARDO CENTER DR STE K13
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92128-2546
Practice Address - Country:US
Practice Address - Phone:858-673-1244
Practice Address - Fax:858-673-1246
Is Sole Proprietor?:No
Enumeration Date:2007-10-17
Last Update Date:2007-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA3710431174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist