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General NPI Number Information
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NPI Number | 1366310773
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Entity Type | Individual
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Provider Name | ROMARIO LUCKHOO
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Gender | Male
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Dates
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Enumeration Date | 10/27/2025
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Last Update Date | 10/27/2025
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Provider Practice Location Address
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Address Line | 24321 COUNTY ROAD 96
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City | DAVIS
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State | CA
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Zip | 95616-9532
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Country | US
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Telephone | 530-753-1653
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Fax |
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Provider Business Mailing Address
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Address Line | 26 SIMMONS WAY APT 3
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City | DAVIS
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State | CA
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Zip | 95616-2433
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Country | US
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Telephone | 530-758-2160
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Fax |
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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 | 373H00000X
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Taxonomy Name | Day Training/Habilitation Specialist
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License Number |
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License Number State | CA
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