| Lucid Lane Providers, P.c. | |
|
3251 Place Du Jardin Optional San Jose CA 95148-9514 | |
| (630) 589-2730 | |
| Not Available |
| Full Name | Lucid Lane Providers, P.c. |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 3251 Place Du Jardin, San Jose, California |
| Authorized Official Name and Position | Mubeena Siddiqui (DIRECTOR OF RCM AND COMPLIANCE) |
| Authorized Official Contact | 6305892730 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lucid Lane Providers, P.c. 3251 Place Du Jardin San Jose CA 95148-3851 Ph: (630) 589-2730 | Lucid Lane Providers, P.c. 3251 Place Du Jardin Optional San Jose CA 95148-9514 Ph: (630) 589-2730 |
| NPI Number | 1912507021 |
|---|---|
| Provider Enumeration Date | 10/28/2020 |
| Last Update Date | 01/29/2021 |
| Certification Date | 10/28/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912507021 | NPI | - | NPPES |
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