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General NPI Number Information
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NPI Number | 1003740432
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Entity Type | Individual
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Provider Name | MEEGAN MASSIE LUCORE
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Gender | Female
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Dates
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Enumeration Date | 06/10/2026
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Last Update Date | 06/10/2026
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Provider Practice Location Address
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Address Line | 168 S 3RD AVE
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City | OAKDALE
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State | CA
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Zip | 95361-3935
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Country | US
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Telephone | 209-848-4884
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Fax |
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Provider Business Mailing Address
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Address Line | 10705 OAK VALLEY RD
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City | ANGELS CAMP
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State | CA
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Zip | 95222-9627
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Country | US
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Telephone | 209-848-4884
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Fax | 209-847-0155
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | SP11074
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License Number State | CA
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