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General NPI Number Information
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NPI Number | 1699180216
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Entity Type | Individual
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Provider Name | SANDEE LUCERO N.P.
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Gender | Female
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Dates
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Enumeration Date | 06/23/2014
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Last Update Date | 06/24/2014
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Provider Practice Location Address
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Address Line | 1045 W FOOTHILL
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City | UPLAND
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State | CA
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Zip | 91786
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Country | US
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Telephone | 909-985-7188
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Fax |
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Provider Business Mailing Address
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Address Line | 6290 PHILLIPS WAY
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91737-3633
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Country | US
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Telephone | 626-278-0839
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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 | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | 17761
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License Number State | CA
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