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NPI Code Detail

MEDICARE: LUCIA BRITT CAMPBELL

MEDICARE: LUCIA BRITT CAMPBELL
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
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1720798762
Entity Type Code : Individual
Provider Name (Legal Business Name) : LUCIA BRITT CAMPBELL
Provider Business Mailing Address
First Line : 4731 CALIFORNIA ST
Second Line :
City : SAN FRANCISCO
State : CA
Zip : 94118-1128
Country : US
Telephone Number : 510-973-9636
Fax Number :
Provider Business Practice Location Address
First Line : 1909 UNIVERSITY AVE
Second Line :
City : BERKELEY
State : CA
Zip : 94704-1023
Country : US
Telephone Number : 510-809-3004
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/30/2022
Last Update Date : 11/30/2022

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Directions to “ LUCIA BRITT CAMPBELL ” Practice Location

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