MS. Theres Luckose
NPI #1255675781 in San Quentin, California
Provider Information
- NPI Number
- 1255675781
- Entity Type
- Individual
- Name
- MS. Theres Luckose
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Social Worker - Clinical
- Enumeration Date
- Nov 21, 2012
- Last Updated
- Jan 10, 2023
Practice Location
- Address
- 1 MAIN ST
- City
- San Quentin
- State
- California
- ZIP Code
- 94964-1000
- Phone
- (415) 454-1460
Specialties & Taxonomy Codes
| Specialty |
|---|
| Social Worker - Clinical — Clinical |
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