MEDICARE: MRS. ANALICIA CHRISTINE LUCAS M.S., CCC-SLP

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	235Z00000X	Speech-Language Pathologist	SP20898	CA

General Provider Information

NPI Number	:	1073949129
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ANALICIA CHRISTINE LUCAS M.S., CCC-SLP

Provider Business Mailing Address
First Line	:	6392 LAKE ATHABASKA PL
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92119-3530
Country	:	US
Telephone Number	:	361-443-1267
Fax Number	:

Provider Business Practice Location Address
First Line	:	3530 CAMINO DEL RIO N
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92108-1743
Country	:	US
Telephone Number	:	858-304-6440
Fax Number	:

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

Provider Enumeration Date	:	09/20/2013
Last Update Date	:	12/07/2015

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Directions to “ MRS. ANALICIA CHRISTINE LUCAS M.S., CCC-SLP” Practice Location

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