Healthcare Provider Details

I. General information

NPI: 1790936326
Provider Name (Legal Business Name): DEBBIE L. BENSCOTER LUKEHART
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/01/2008
Last Update Date: 10/01/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2201 TUOLUMNE ST
VALLEJO CA
94589-2524
US

IV. Provider business mailing address

210 PEMBROKE CT
VACAVILLE CA
95687-5930
US

V. Phone/Fax

Practice location:
  • Phone: 707-558-1777
  • Fax: 707-558-1770
Mailing address:
  • Phone: 707-558-1777
  • Fax: 705-581-7770

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: