Provider Demographics
NPI:1912275611
Name:LUCIER, HEATHER DANIELLE (CATC 1)
Entity type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:DANIELLE
Last Name:LUCIER
Suffix:
Gender:F
Credentials:CATC 1
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:557 D ST
Mailing Address - Street 2:
Mailing Address - City:UPLAND
Mailing Address - State:CA
Mailing Address - Zip Code:91786-5370
Mailing Address - Country:US
Mailing Address - Phone:909-509-6760
Mailing Address - Fax:
Practice Address - Street 1:557 D ST
Practice Address - Street 2:
Practice Address - City:UPLAND
Practice Address - State:CA
Practice Address - Zip Code:91786-5370
Practice Address - Country:US
Practice Address - Phone:909-509-6760
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-08
Last Update Date:2021-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA081581101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)