Jack James Lucas

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

17636 Issued in CA

Practice address

4000 Civic Center Dr
San Rafael, CA 94903-4171

Phone

(628) 877-0040

NPI assigned

May 11, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1620691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620691200000",
    "number": "1831773209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1345 43RD AVE",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941221214",
            "telephone_number": "415-810-3776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 CIVIC CENTER DR",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949034171",
            "telephone_number": "628-877-0040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUCAS",
        "first_name": "JACK",
        "middle_name": "JAMES",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-05-11",
        "last_updated": "2021-05-11",
        "certification_date": "2021-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "17636",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeffrey A. Lovold, MD
• Robert A. Lowell, MD
• Iris Rebecca Lowenberg-Lin, FNP
• Aaron Jeremy Lowers, AOD COUNSELOR
• Jennifer Loyer, MA, LMFT
• Anne Marie Luger
• Amanda Lui
• Emmeline Lui, RDH
• Lisa Wynland Lukianoff
• Clarisse Valerie Lula, MA, MFT

• All providers in San Rafael, CA
• Occupational Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.