Individual
BLAKE ANTHONY LUCAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2049 SKYLINE DR, LEMON GROVE, CA 91945-4221
(619) 465-7303
(619) 644-2503
Mailing address
1400 N JOHNSON AVE STE 101, EL CAJON, CA 92020-1651
(619) 442-0277
(619) 442-1592
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
12/23/2019
Last updated
12/23/2019
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