MEDICARE: SHARON NICOLE LUGO MED

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	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1134711443
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHARON NICOLE LUGO MED

Provider Business Mailing Address
First Line	:	9620 CHESAPEAKE DR STE 105
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92123-1324
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1822 CAROLYN DR
Second Line	:
City	:	CHULA VISTA
State	:	CA
Zip	:	91913-2635
Country	:	US
Telephone Number	:	619-770-4882
Fax Number	:

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

Provider Enumeration Date	:	02/08/2021
Last Update Date	:	02/09/2026

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Directions to “ SHARON NICOLE LUGO MED” Practice Location

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