Marylyn Sheila Lucas, SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SP9772 Issued in CA

Practice address

5819 Chenault Dr
Modesto, CA 95356-9621

Phone

(209) 572-0793

NPI assigned

Dec 3, 2012

Sex

Female

Sole proprietor

Yes

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

State licenses

Practice roles

Locations

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.

• Blossom Speech and Language Therapy

  • Speech-Language Pathologist
  • Modesto, CA
  • NPI 1164174694
  NPD Authorized official
• Blossom Speech and Language Therapy TN, Inc.

  • Speech-Language Pathologist
  • Modesto, CA
  • NPI 1477354389
  NPD Authorized official

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

{
    "created_epoch": "1354492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354492800000",
    "number": "1992040968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5819 CHENAULT DR",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953569621",
            "telephone_number": "209-572-0793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5819 CHENAULT DR",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953569621",
            "telephone_number": "209-572-0793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUCAS",
        "first_name": "MARYLYN",
        "middle_name": "SHEILA",
        "name_prefix": "Mrs.",
        "credential": "SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-12-03",
        "last_updated": "2012-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "SP9772",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Estephanie Lua de la Torre
• Lubrime Integrative LLC
• Christopher Lucas, PHARMD
• Emily Lucas
• Erin Lucas, SLP-CCC
• Michelle Lucas
• Elisa Lucero
• Lorenzo Lucero
• Lucky 7 Taxi
• Daniel S Lucky, MSN, FNP-C, GNP-C,

• Speech-Language Pathologist in Modesto, CA
• Providers in Modesto, CA by specialty
• Speech-Language Pathologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2012; 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.