Provider Demographics
NPI:1164180774
Name:HARRIS-LUCAS, DANIEL KEHINDE
Entity type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:KEHINDE
Last Name:HARRIS-LUCAS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1723 86TH AVE
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94621-1563
Mailing Address - Country:US
Mailing Address - Phone:415-960-7467
Mailing Address - Fax:
Practice Address - Street 1:1723 86TH AVE
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94621-1563
Practice Address - Country:US
Practice Address - Phone:415-960-7467
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-30
Last Update Date:2024-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator