Individual provider Active NPI

Deborah K. Lucas, D.O.

  • Psychiatry Physician
  • Riverside, CA
National Provider Identifier
1376758128
Registry record updated Jan 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
20A8556 Issued in CA
Practice address
2085 Rustin Ave # 5
Riverside, CA 92507-2498
Phone
(951) 955-7320
NPI assigned
May 14, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 20A8556 CA Primary

Addresses

Primary practice location

2085 Rustin Ave # 5
Riverside, CA 92507-2498

Mailing address

2085 Rustin Ave # 5
Riverside, CA 92507-2498

Other practice location 1

4211 Avalon Blvd
Los Angeles, CA 90011-5622
Phone (323) 432-5185

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101015000419 CA Practitioner - PsychiatryPractitioner - Osteopathic Manipulative Medicine 8820281488 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
20A8556CAMDPsychiatry Physician
8556CAMDGeriatric Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Mellow Medical Inc a Professional Corporation Psychiatry CurrentSince Oct 21, 2020 Accepting new patients
Central City Community Health Center Inc CurrentSince Feb 23, 2025 Accepting new patients
Central City Community Health Center Inc CurrentSince Feb 23, 2025 Accepting new patients
Central City Community Health Center Inc Current Accepting new patients
Ehab Yacoub MD Inc. CurrentSince Mar 24, 2020 Accepting new patients
Gregor Medical Corporation PastSince Apr 10, 2022 Accepting new patients

Locations

1225 W 190th St
Ste 280
Gardena, CA 90248
Phone (310) 515-8113

12301 Wilshire Blvd
Ste 512
Los Angeles, CA 90025
Phone (833) 427-3566

2019 Saturn St
Monterey Park, CA 91755
Phone (323) 724-0019

1860 Hamner Ave
Norco, CA 92860
Phone (951) 479-0070

17075 Devonshire St
Ste 204
Northridge, CA 91325
Phone (818) 368-8929

268 McArthur Way
Ste A
Upland, CA 91786
Phone (909) 406-5353

8235 Santa Monica Blvd
Ste 302
West Hollywood, CA 90046
Phone (310) 892-4284

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/9357/brand/1/csg/1/fhir/r4

Organizations & group practices 6

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

NPI Registry JSON

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

{
    "created_epoch": "1179100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641859200000",
    "number": "1376758128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2085 RUSTIN AVE # 5",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925072498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2085 RUSTIN AVE # 5",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925072498",
            "telephone_number": "951-955-7320"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4211 Avalon Blvd",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900115622",
            "country_code": "US",
            "telephone_number": "323-432-5185",
            "fax_number": "323-432-5086",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LUCAS",
        "first_name": "DEBORAH",
        "middle_name": "K.",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-14",
        "last_updated": "2022-01-11",
        "certification_date": "2022-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "20A8556",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

Verify at the official NPI Registry.