Individual
YACUB LUCAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
974 PARK RANCH WAY, SACRAMENTO, CA 95831-3064
(916) 997-9130
(916) 515-8013
Mailing address
974 PARK RANCH WAY, SACRAMENTO, CA 95831-3064
(916) 997-9130
Taxonomy
Speciality
Code
Description
License number
State
376G00000X
Nursing Home Administrator
Primary
6051257740
CA
Other
Enumeration date
01/11/2023
Last updated
01/11/2023
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