MEDICARE: LUCERO SOSA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker	131232	CA

General Provider Information

NPI Number	:	1013888015
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LUCERO SOSA

Provider Business Mailing Address
First Line	:	PO BOX 2045
Second Line	:
City	:	WESTMINSTER
State	:	CA
Zip	:	92684-2045
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2801 BRISTOL ST
Second Line	:
City	:	COSTA MESA
State	:	CA
Zip	:	92626-5996
Country	:	US
Telephone Number	:	714-850-8408
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/15/2025
Last Update Date	:	12/17/2025

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Directions to “ LUCERO SOSA ” Practice Location

Language	Start Address	Practice Location

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