Active NPI
John Chapman Lucas, PH.D.
- Psychologist
- Santa Rosa, CA
National Provider Identifier
1639365992
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- LEP867
- Practice address
- 1144 Sonoma Ave
Suite 111
Santa Rosa, CA 95405-4812 - Phone
- (707) 576-0576
- Fax
- (707) 576-7559
- NPI assigned
- Sep 20, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | LEP867 | CA | Primary |
Addresses
Primary practice location
1144 Sonoma Ave
Suite 111
Santa Rosa, CA 95405-4812
Mailing address
1144 Sonoma Ave
Suite 111
Santa Rosa, CA 95405-4812
Phone (707) 576-0576
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
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LEP867 | CA | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1190246400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1190246400000",
"number": "1639365992",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1144 SONOMA AVE",
"address_2": "SUITE 111",
"city": "SANTA ROSA",
"state": "CA",
"postal_code": "954054812",
"telephone_number": "707-576-0576",
"fax_number": "707-576-7559"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1144 SONOMA AVE",
"address_2": "SUITE 111",
"city": "SANTA ROSA",
"state": "CA",
"postal_code": "954054812",
"telephone_number": "707-576-0576",
"fax_number": "707-576-7559"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUCAS",
"first_name": "JOHN",
"middle_name": "CHAPMAN",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-09-20",
"last_updated": "2007-09-20",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CA",
"license": "LEP867",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Santa Rosa, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.