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Individual

GENTLE F LUCARIO HEADLEY LEWIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1774 ZONAL AVE BLDG C, LOS ANGELES, CA 90033-1064
(310) 221-6336
Mailing address
1774 ZONAL AVE BLDG C, LOS ANGELES, CA 90033-1064
(310) 221-6336

Taxonomy

Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
751764
CA
171M00000X
Case Manager/Care Coordinator
CA

Other

Enumeration date
11/01/2017
Last updated
02/12/2026
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