Provider Demographics
NPI:1851275788
Name:LUCERO, DANTE (MSW, ACSW)
Entity type:Individual
Prefix:
First Name:DANTE
Middle Name:
Last Name:LUCERO
Suffix:
Gender:M
Credentials:MSW, ACSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1971 PASEO DEL REY
Mailing Address - Street 2:
Mailing Address - City:VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:92084-2580
Mailing Address - Country:US
Mailing Address - Phone:805-448-3751
Mailing Address - Fax:
Practice Address - Street 1:314 S MELROSE DR STE 100
Practice Address - Street 2:
Practice Address - City:VISTA
Practice Address - State:CA
Practice Address - Zip Code:92081-6669
Practice Address - Country:US
Practice Address - Phone:805-448-3751
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-04
Last Update Date:2025-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1323521041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical