MEDICARE: NERI YOVANI LUCERO

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	172V00000X	Community Health Worker		CA

General Provider Information

NPI Number	:	1053270983
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NERI YOVANI LUCERO

Provider Business Mailing Address
First Line	:	PO BOX 556
Second Line	:
City	:	HOPLAND
State	:	CA
Zip	:	95449-0556
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	550 RANCHO GRAND RD
Second Line	:
City	:	HOPLAND
State	:	CA
Zip	:	95449
Country	:	US
Telephone Number	:	707-513-3346
Fax Number	:

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

Provider Enumeration Date	:	01/16/2026
Last Update Date	:	01/16/2026

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Directions to “ NERI YOVANI LUCERO ” Practice Location

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