Healthcare Provider Details

I. General information

NPI: 1306360664
Provider Name (Legal Business Name): THOMAS LUCKING PHD, LMFT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2017
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14375 SARATOGA AVE STE 206
SARATOGA CA
95070-5989
US

IV. Provider business mailing address

PO BOX 2013
LOS GATOS CA
95031-2013
US

V. Phone/Fax

Practice location:
  • Phone: 408-409-4167
  • Fax: 408-872-4001
Mailing address:
  • Phone: 408-409-4167
  • Fax: 408-872-4001

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number97696
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: