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General NPI Number Information
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NPI Number | 1538981493
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Entity Type | Individual
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Provider Name | DIEGO A LUCERO
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Gender | Male
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Dates
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Enumeration Date | 10/30/2024
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Last Update Date | 10/30/2024
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Provider Practice Location Address
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Address Line | 1849 WILLOW PASS RD STE 400
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City | CONCORD
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State | CA
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Zip | 94520-2581
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Country | US
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Telephone | 925-825-1081
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Fax |
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Provider Business Mailing Address
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Address Line | 1181 CLAIBORNE DR
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City | WALNUT CREEK
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State | CA
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Zip | 94598-1528
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Country | US
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Telephone | 510-862-7963
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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 | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number | 35722
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License Number State | CA
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