Active NPI
Roxanna Jacqueline Lucero, FNP
- Family Nurse Practitioner
- Rialto, CA
National Provider Identifier
1194833525
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 15277
- Practice address
- 6662 Yucca Ave
Rialto, CA 92376-2631 - Phone
- (909) 877-3746
- Fax
- (909) 820-6465
- NPI assigned
- Aug 27, 2006
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 15277 | CA | Primary |
Addresses
Primary practice location
6662 Yucca Ave
Rialto, CA 92376-2631
Mailing address
6662 Yucca Ave
Rialto, CA 92376-2631
Phone (909) 877-3746
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 15277 | Other | CA | CA BOARD OF REG. NURSING |
| 2004003487-22 | Other | AMERICAN NURSES CREDENTIA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15277 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156636800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1194833525",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6662 YUCCA AVE",
"city": "RIALTO",
"state": "CA",
"postal_code": "923762631",
"telephone_number": "909-877-3746",
"fax_number": "909-820-6465"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6662 YUCCA AVE",
"city": "RIALTO",
"state": "CA",
"postal_code": "923762631",
"telephone_number": "909-877-3746",
"fax_number": "909-820-6465"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUCERO",
"first_name": "ROXANNA",
"middle_name": "JACQUELINE",
"name_prefix": "Mrs.",
"credential": "FNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-27",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "CA",
"license": "15277",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CA BOARD OF REG. NURSING",
"identifier": "15277",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERICAN NURSES CREDENTIA",
"identifier": "2004003487-22",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Rialto, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.