Individual provider Active NPI

Anthony Lucero

  • Psychiatric/Mental Health Nurse Practitioner
  • Loma Linda, CA
National Provider Identifier
1356931182
Registry record updated Feb 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
95022856 Issued in CA
Practice address
11262 Campus St
Loma Linda, CA 92350-1727
Phone
(909) 558-1000
NPI assigned
Jan 25, 2021
Last updated
Feb 16, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 95022856 CA Primary

Addresses

Primary practice location

11262 Campus St
Loma Linda, CA 92350-1727

Mailing address

11262 Campus St
Loma Linda, CA 92350-1727

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230830004203 CA Practitioner - Nurse Practitioner 7012370588 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
88.87 of 100Reported as group
Quality
72.13
Promoting interoperability
80
Improvement activities
40
Cost
77.36

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95022856CAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Faculty Physicians and Surgeons of Llusm Current Accepting new patients
Southern California TMS Center Inc CurrentSince Jun 11, 2023 Accepting new patients
Faculty Physicians and Surgeons of Llusm CurrentSince Aug 1, 2023 Accepting new patients
Faculty Physicians and Surgeons of Llusm CurrentSince Aug 1, 2023 Accepting new patients

Locations

2045 Compton Ave
Ste 205
Corona, CA 92881

940 S Coast Dr
Ste 215
Costa Mesa, CA 92626

16055 Ventura Blvd
Ste 717
Encino, CA 91436
Phone (818) 215-0367

700 N Brand Blvd
Ste 460
Glendale, CA 91203
Phone (310) 488-0329

23832 Rockfield Blvd
Ste 130
Lake Forest, CA 92630
Phone (949) 297-6680

11370 Anderson St
#B100
Loma Linda, CA 92354
Phone (909) 558-2848

3711 Long Beach Blvd
Ste 910
Long Beach, CA 90807

2100 Sawtelle Blvd
Ste 206
Los Angeles, CA 90025
Phone (310) 467-5071

4221 Wilshire Blvd
Ste 455
Los Angeles, CA 90010

File Number 54701
Los Angeles, CA 90074
Phone (909) 651-4300

180 S Lake Ave
Ste 615
Pasadena, CA 91101
Phone (626) 683-9158

711 W Kimberly Ave
Ste 100
Placentia, CA 92870

10630 Town Center Dr
Ste 129
Rancho Cucamonga, CA 91730

1686 Barton Rd
Redlands, CA 92373
Phone (909) 558-9200

299 W Hillcrest Dr
Ste 113
Thousand Oaks, CA 91360

3655 Torrance Blvd
Ste 240
Torrance, CA 90503

Interoperability endpoints

  • Direct secure messaging: alucero78976@direct.llu.edu

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1611532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676505600000",
    "number": "1356931182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11262 CAMPUS ST",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923501727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11262 CAMPUS ST",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923501727",
            "telephone_number": "909-558-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUCERO",
        "first_name": "ANTHONY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-01-25",
        "last_updated": "2023-02-16",
        "certification_date": "2023-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95022856",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Loma Linda, CA

Sources for this page

Verify at the official NPI Registry.