Individual
SONIA GORDON LUCKEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DNP, APRN
Contact information
Practice address
638 CAMINO DE LOS MARES, SAN CLEMENTE, CA 92673
(949) 494-8426
Mailing address
503 VIA DESEO, SAN CLEMENTE, CA 92672-2462
(714) 822-7195
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
202000873
OR
363LF0000X
Family Nurse Practitioner
AP60944156
WA
363LF0000X
Family Nurse Practitioner
RN449787
CA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
RN449787
CA
Other
Enumeration date
05/11/2017
Last updated
04/16/2021
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