Healthcare Provider Details

I. General information

NPI: 1780506089
Provider Name (Legal Business Name): YUNIBA LUCERO GONZALEZ LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: YUNIBA LUCERO BANOS

II. Dates (important events)

Enumeration Date: 07/28/2026
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1960 E PALO VERDE ST STE 1
YUMA AZ
85365-3537
US

IV. Provider business mailing address

3101 N CENTRAL AVE STE 550
PHOENIX AZ
85012-2635
US

V. Phone/Fax

Practice location:
  • Phone: 602-230-7373
  • Fax: 928-339-8186
Mailing address:
  • Phone: 602-230-7373
  • Fax: 602-682-7455

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberLMSW-08427T
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: