Individual
JACK JAMES LUCAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4000 CIVIC CENTER DR, SAN RAFAEL, CA 94903-4171
(628) 877-0040
Mailing address
1345 43RD AVE, SAN FRANCISCO, CA 94122-1214
(415) 810-3776
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
17636
CA
Other
Enumeration date
05/11/2021
Last updated
05/11/2021
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