Healthcare Provider Details

I. General information

NPI: 1912517236
Provider Name (Legal Business Name): CYNTHIA LUCIO NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/01/2020
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2801 E SPRING ST STE 120
LONG BEACH CA
90806-6840
US

IV. Provider business mailing address

2801 E SPRING ST STE 120
LONG BEACH CA
90806-6840
US

V. Phone/Fax

Practice location:
  • Phone: 708-263-7321
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number209021242
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: