Dominic G Lucia, M.A., ED.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSB94022435 Issued in CA

Practice address

1824 Empire Industrial CT
Suite 'C'
Santa Rosa, CA 95403-1991

Phone

(707) 548-3368

Fax

(707) 843-7639

NPI assigned

Jul 19, 2016

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1468886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490054400000",
    "number": "1053764688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1824 EMPIRE INDUSTRIAL CT",
            "address_2": "SUITE 'C'",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954031991",
            "telephone_number": "707-548-3368",
            "fax_number": "707-843-7639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1824 EMPIRE INDUSTRIAL CT",
            "address_2": "SUITE 'C'",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954031991",
            "telephone_number": "707-548-3368",
            "fax_number": "707-843-7639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUCIA",
        "first_name": "DOMINIC",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "M.A., ED.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-07-19",
        "last_updated": "2017-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSB94022435",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Frances Hungyi Lu, MD
• Song CHI Lu, MD
• Nicholas Lubega
• Monique Lucarelli
• John Chapman Lucas, PH.D.
• Kathryn Susanne Luciani
• Lucky Stores II LLC
• Heather Ludvigson, LCSW
• Connie Lee Luebkeman
• Jeremy Luena, COTA/L

• Clinical Psychologist in Santa Rosa, CA
• Providers in Santa Rosa, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.