SONIA GORDON LUCKEY (NPI# 1093242851) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093242851 |
| Entity Type | Individual |
| Full Name | SONIA GORDON LUCKEY |
| Credential | DNP, APRN |
| Practice Address |
638 Camino De Los Mares San Clemente CA 92673 |
| Mailing Address |
503 Via Deseo San Clemente CA 92672-2462 |
| Practice Telephone | 9494948426 |
| Mailing Telephone | 7148227195 |
| Enumeration Date | 2017-05-11 |
| Last Update Date | 2020-08-11 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
202000873 | OR | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
AP60944156 | WA | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
RN449787 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
RN449787 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
638 CAMINO DE LOS MARES |
| City | SAN CLEMENTE |
| State | CA |
| Zip Code | 92673 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922042274 | Garfield Beach Cvs LLC | Pharmacy | 638 Camino De Los Mares, San Clemente, CA 92673-2848 | 2006-06-16 |
| 1790324978 | Reza Khodadadi | Pharmacy | 638 Camino De Los Mares, San Clemente, CA 92673-2848 | 2020-01-05 |
| 1225677628 | Samey Abdulrub | Pharmacist | 638 Camino De Los Mares, San Clemente, CA 92673-2848 | 2020-01-02 |
| 1194291096 | Victoria Deangelo | Pharmacist | 638 Camino De Los Mares, San Clemente, CA 92673-2848 | 2018-10-17 |
| 1083116586 | Victoria Lynn Whalen | Nurse Practitioner | 638 Camino De Los Mares, San Clemente, CA 92673-2848 | 2018-03-01 |
| 1821527110 | Sima Patel | Pharmacist | 638 Camino De Los Mares, San Clemente, CA 92673 | 2017-06-08 |
| 1780119289 | Stephanie Chiu | Pharmacist | 638 Camino De Los Mares, San Clemente, CA 92673-2848 | 2017-04-22 |
| 1003347816 | Katarzyna Anna Hudson | Nurse Practitioner | 638 Camino De Los Mares, San Clemente, CA 92673-2848 | 2017-03-23 |
| 1205253002 | Home Sleep Partners | Clinical Medical Laboratory | 638 Camino De Los Mares, Suite H130-600, San Clemente, CA 92673-2848 | 2014-03-19 |
| 1306071055 | Jean M Lim Optometry, Inc | Optometrist | 638 Camino De Los Mares, A120, San Clemente, CA 92673-2848 | 2009-05-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497246474 | Cynthia Hull Warren | Nutritionist | 2027 Via Concha, San Clemente, CA 92673 | 2018-05-24 |
| 1063942688 | Trinh T Tran | Pharmacist | 638 Camino De Los Mares #d5, San Clemente, CA 92673 | 2017-06-15 |
| 1427421791 | Jessica A Currens | Nurse Practitioner | 1001 Avenida Pico Ste C517, San Clemente, CA 92673 | 2015-11-08 |
| 1184010647 | Garrett Bryon Rubio | Student in an Organized Health Care Education/Training Program | 905 Calle Amanecer Ste. 265, San Clemente, CA 92673 | 2015-04-11 |
| 1255733853 | Body Mind Spirit Iop Inc | Psychologist | 665 Camino De Los Mares Ste 104, San Clemente, CA 92673 | 2014-09-25 |
| 1548677438 | Jessica Ann Riley | Dermatology | 1300 Avenida Vista Hermosa Ste 150, San Clemente, CA 92673 | 2014-07-13 |
| 1427398718 | Veena Menda | Specialist | 2232 Calle Opalo, San Clemente, CA 92673 | 2013-02-22 |
| 1124383781 | Alexandra Rose Corporation | Substance Abuse Rehabilitation Facility | 4009 Calle Abril, San Clemente, CA 92673 | 2012-07-10 |
| 1457612574 | Noelle J Deckman | Psychologist | 629 Camino De Los Mares Ste 207a, San Clemente, CA 92673 | 2012-06-05 |
| 1851686471 | Meighan Bartholomew Merono | Pharmacist | 990 Avenida Vista Hermosa, San Clemente, CA 92673 | 2011-06-10 |
| Find all providers in zip 92673 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477154573 | Marcus Jang | Nurse Practitioner | 1130 E Colorado St Apt 214, Glendale, CA 91205-2092 | 2020-11-04 |
| 1033718580 | John Sylvanus Allieu Sr. | Nurse Practitioner | 2672 Merganser Ct, Los Banos, CA 93635-9473 | 2020-10-25 |
| 1316546930 | Chika U Oguagha | Nurse Practitioner | 16240 Carmine St, Fontana, CA 92336-1481 | 2020-10-23 |
| 1215534888 | Rosa Maria Aguero | Nurse Practitioner | 9841 Alburtis Ave Unit 29, Santa Fe Springs, CA 90670-3264 | 2020-10-06 |
| 1134726995 | Margarita Maghtesyan | Nurse Practitioner | 20251 Ventura Blvd Ste A, Woodland Hills, CA 91364-2564 | 2020-10-05 |
| 1043827140 | April Lopez Ortiz | Nurse Practitioner | 500 W Ashland Ct, Visalia, CA 93277-6609 | 2020-09-23 |
| 1477167666 | David Joseph Russell | Nurse Practitioner | 17846 Glenwood Rd, Manteca, CA 95336-9521 | 2020-09-03 |
| 1194339382 | Albert Liu | Nurse Practitioner | 43559 Southerland Way, Fremont, CA 94539-5931 | 2020-09-03 |
| 1407469554 | Andre Alexandrian | Nurse Practitioner | 1606 Winona Ave, Burbank, CA 91504-2823 | 2020-08-28 |
| 1790398238 | Heather Richardson | Nurse Practitioner | 112 S Park St Ste 1, San Francisco, CA 94107-1809 | 2020-08-25 |
| Find all providers with the same taxonomy | ||||
| City | SAN CLEMENTE |
| Zip Code | 92673 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.