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NPI Code Detail

MEDICARE: MS. KRISTINE LUCAS MA,OTR/L

MEDICARE: MS. KRISTINE LUCAS MA,OTR/L
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
1225XP0200XPediatric Occupational Therapist
2225X00000XOccupational TherapistOT13514CA

General Provider Information

NPI Number : 1770910382
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. KRISTINE LUCAS MA,OTR/L
Provider Business Mailing Address
First Line : 2625 TOWNSGATE RD STE 102
Second Line :
City : WESTLAKE VILLAGE
State : CA
Zip : 91361-5726
Country : US
Telephone Number : 858-776-4689
Fax Number :
Provider Business Practice Location Address
First Line : 2625 TOWNSGATE RD STE 102
Second Line :
City : WESTLAKE VILLAGE
State : CA
Zip : 91361-5726
Country : US
Telephone Number : 888-776-4689
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/27/2013
Last Update Date : 07/20/2023

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