Active NPI
Jonathan Edward Lucero, LMFT
- Marriage & Family Therapist
- Laguna Hills, CA
National Provider Identifier
1407366495
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 112931
- Practice address
- 23161 Mill Creek Dr Ste 230
Laguna Hills, CA 92653-7935 - Phone
- (949) 264-5350
- NPI assigned
- Oct 4, 2017
- 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 | 112931 | CA | Primary |
Addresses
Primary practice location
23161 Mill Creek Dr Ste 230
Laguna Hills, CA 92653-7935
Mailing address
PO Box 957
Anaheim, CA 92815-0957
Other practice location 1
12141 Brookhurst St Ste 201
Garden Grove, CA 92840-2865
Phone (657) 261-7140
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq | Health Information Exchange (HIE) | Southern California Permanente Medical Group |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Telecare Corporation | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Garden Grove, CA
- NPI 1992312805
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1507075200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1728950400000",
"number": "1407366495",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 957",
"city": "ANAHEIM",
"state": "CA",
"postal_code": "928150957"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "23161 MILL CREEK DR STE 230",
"city": "LAGUNA HILLS",
"state": "CA",
"postal_code": "926537935",
"telephone_number": "949-264-5350"
}
],
"practiceLocations": [
{
"address_1": "12141 Brookhurst St Ste 201",
"address_purpose": "LOCATION",
"city": "Garden Grove",
"state": "CA",
"postal_code": "928402865",
"country_code": "US",
"telephone_number": "657-261-7140",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LUCERO",
"first_name": "JONATHAN",
"middle_name": "EDWARD",
"credential": "LMFT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-10-04",
"last_updated": "2024-10-15",
"certification_date": "2023-07-25",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "112931",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
"affiliation": "Y",
"endpointDescription": "Carequality",
"affiliationName": "Southern California Permanente Medical Group",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "C-CDA",
"address_1": "1011 Baldwin Park Blvd",
"city": "Baldwin Park",
"state": "CA",
"country_code": "US",
"postal_code": "917065806",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Laguna Hills, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.