Healthcare Provider Details

I. General information

NPI: 1396661153
Provider Name (Legal Business Name): AUDRA CLAIRE LUCAS CMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/26/2026
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7520 GARFIELD AVE
OAKLAND CA
94605-2818
US

IV. Provider business mailing address

7520 GARFIELD AVE
OAKLAND CA
94605-2818
US

V. Phone/Fax

Practice location:
  • Phone: 510-927-7789
  • Fax:
Mailing address:
  • Phone: 510-927-7789
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number102666
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: