Active NPI
Clement Miles Lucero, M.A., MFT, INTERN
- Marriage & Family Therapist
- Yucca Valley, CA
National Provider Identifier
1376688077
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- IMF64396
- Practice address
- 58945 Business Center Dr. #D
Yucca Valley, CA 92284-7307 - Phone
- (760) 228-9657
- NPI assigned
- Feb 20, 2007
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | IMF64396 | CA | Primary |
Addresses
Primary practice location
58945 Business Center Dr. #D
Yucca Valley, CA 92284-7307
Mailing address
7696 Borrego Trail
Yucca Valley, CA 92284-6374
Phone (760) 808-4517
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)
- Not enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| IMF64396 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171929600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1346284800000",
"number": "1376688077",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7696 BORREGO TRAIL",
"city": "YUCCA VALLEY",
"state": "CA",
"postal_code": "922846374",
"telephone_number": "760-808-4517"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "58945 BUSINESS CENTER DR. #D",
"city": "YUCCA VALLEY",
"state": "CA",
"postal_code": "922847307",
"telephone_number": "760-228-9657"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUCERO",
"first_name": "CLEMENT",
"middle_name": "MILES",
"credential": "M.A., MFT, INTERN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-02-20",
"last_updated": "2012-08-30",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "IMF64396",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Yucca Valley, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.