Bonnie D Lucks, PH.D

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY 22788 Issued in CA

Practice address

6367 Alvarado CT Ste 200
San Diego, CA 92120-4915

Phone

(619) 069-0777

Fax

(619) 563-4559

NPI assigned

Feb 19, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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.

• Lucks Psychology, Inc

  • Group Psychotherapy Psychologist
  • San Diego, CA
  • NPI 1841421328
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1171843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659052800000",
    "number": "1609910876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 191274",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921591274",
            "telephone_number": "619-500-4658",
            "fax_number": "619-563-4559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6367 ALVARADO CT STE 200",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921204915",
            "telephone_number": "619-069-0777",
            "fax_number": "619-563-4559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUCKS",
        "first_name": "BONNIE",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "PH.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-19",
        "last_updated": "2022-07-29",
        "certification_date": "2022-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSB 22788",
            "primary": false
        },
        {
            "code": "103TP2701X",
            "taxonomy_group": "",
            "desc": "Psychologist, Group Psychotherapy",
            "state": "CA",
            "license": "PSY 22788",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY 22788",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Simon Joseph Lucio, M.D.
• Sean William Luck
• Valencia Tatania Luckman, D.O.
• Amelia Luckow, PA-C
• Lucks Psychology, Inc
• Chloe Mae Lucksanalamai
• Luczynski Dental Corporation (Uptown Smiles Dentistry)
• Paul Luczynski, D.D.S.
• Julia Catherine Brumitt Ludd
• Sparghai Sahar Ludin, MD

• Clinical Psychologist in San Diego, CA
• Providers in San Diego, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.