Luck, Jean Marie

Luck, Jean Marie is an sole proprietor health care provider with primary practice located at 33420 Robindr. , Green Valley Lake CA 92341-8327. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as her primary health care specialty. Luck, Jean Marie can be contacted via phone (909) 379-9894.

Contact Information

Primary practice address
33420 Robindr. Green Valley Lake CA 92341-8327
Phone: (909) 379-9894
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X CAPA15505 California

Profile Details

NPI number 1740322619
LBN Legal business name Luck, Jean Marie
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 13th, 2007
Last updated Jul 9th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1740322619 NPPES
California MEDICAID CAPA15505

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