Healthcare Provider Details

I. General information

NPI: 1326942038
Provider Name (Legal Business Name): LUCIDPATH ADVANCED NURSING PRACTICE PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2026
Last Update Date: 10/06/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

255 W VIA PRADO
ONTARIO CA
91762
US

IV. Provider business mailing address

4016 GRAND AVE STE A
CHINO CA
91710-5491
US

V. Phone/Fax

Practice location:
  • Phone: 951-592-3764
  • Fax: 951-582-2936
Mailing address:
  • Phone: 951-592-3764
  • Fax: 951-582-2936

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number StateNULL

VIII. Authorized Official

Name: SOLOMON DURUJI
Title or Position: CEO
Credential: NP
Phone: 714-476-3859