=====================================================
General NPI Number Information
=====================================================
NPI Number | 1326942038
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | LUCIDPATH ADVANCED NURSING PRACTICE PC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/06/2026
-----------------------------------------------------
Last Update Date | 10/06/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 255 W VIA PRADO
-----------------------------------------------------
City | ONTARIO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91762
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 951-592-3764
-----------------------------------------------------
Fax | 951-582-2936
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4016 GRAND AVE STE A
-----------------------------------------------------
City | CHINO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91710-5491
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 951-592-3764
-----------------------------------------------------
Fax | 951-582-2936
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | SOLOMON DURUJI
-----------------------------------------------------
Credential | NP
-----------------------------------------------------
Telephone | 714-476-3859
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LP0808X
-----------------------------------------------------
Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | NULL
-----------------------------------------------------