Healthcare Provider Details

I. General information

NPI: 1477410652
Provider Name (Legal Business Name): LUCIA NATALE POTTHAST
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

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

III. Provider practice location address

49370 ROAD 426 STE B
OAKHURST CA
93644-9052
US

IV. Provider business mailing address

49370 ROAD 426 STE B
OAKHURST CA
93644-9052
US

V. Phone/Fax

Practice location:
  • Phone: 559-641-6321
  • Fax: 559-641-2359
Mailing address:
  • Phone: 559-641-6321
  • Fax: 559-641-2359

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberASW133659
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: