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NPI Code Detail

MEDICARE: DR. ANN LARAINE DELUCAS PHD

MEDICARE: DR. ANN LARAINE DELUCAS PHD
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
1103TC0700XClinical PsychologistPSY 18018CA

General Provider Information

NPI Number : 1952373482
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ANN LARAINE DELUCAS PHD
Provider Business Mailing Address
First Line : 1146 SAN MARINO DR.
Second Line :
City : SAN MARCOS
State : CA
Zip : 97078
Country : US
Telephone Number : 760-471-2033
Fax Number : 760-471-2083
Provider Business Practice Location Address
First Line : 1146 SAN MARINO DR
Second Line :
City : SAN MARCOS
State : CA
Zip : 92078-4649
Country : US
Telephone Number : 760-471-2033
Fax Number : 760-471-2083
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/07/2006
Last Update Date : 03/26/2015

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Directions to “ DR. ANN LARAINE DELUCAS PHD” Practice Location

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