Provider Demographics
NPI:1497819817
Name:LUCK, LINDA CAROLE
Entity type:Individual
Prefix:MS
First Name:LINDA
Middle Name:CAROLE
Last Name:LUCK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:89 GRINDING ROCK RD
Mailing Address - Street 2:
Mailing Address - City:PARADICE
Mailing Address - State:CA
Mailing Address - Zip Code:95969
Mailing Address - Country:US
Mailing Address - Phone:530-877-9614
Mailing Address - Fax:
Practice Address - Street 1:18 COUNTY CENTER DRIVE
Practice Address - Street 2:
Practice Address - City:OROVILLE
Practice Address - State:CA
Practice Address - Zip Code:95965
Practice Address - Country:US
Practice Address - Phone:530-538-7705
Practice Address - Fax:530-538-2161
Is Sole Proprietor?:No
Enumeration Date:2006-12-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARA847704101YA0400X
CARN 237982163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered163W00000XNursing Service ProvidersRegistered Nurse