MEDICARE: EMELY NATALI LUGO M.A.

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	390200000X	Student in an Organized Health Care Education/Training Program

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	F7944614	OTHER	CA	LICENSE

General Provider Information

NPI Number	:	1770416448
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EMELY NATALI LUGO M.A.

Provider Business Mailing Address
First Line	:	555 OHLONE AVE APT 307
Second Line	:
City	:	ALBANY
State	:	CA
Zip	:	94706-2697
Country	:	US
Telephone Number	:	909-904-8037
Fax Number	:

Provider Business Practice Location Address
First Line	:	555 OHLONE AVE APT 307
Second Line	:
City	:	ALBANY
State	:	CA
Zip	:	94706-2697
Country	:	US
Telephone Number	:	909-904-8037
Fax Number	:

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

Provider Enumeration Date	:	06/04/2026
Last Update Date	:	06/04/2026

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