Basic Information
| Provider Information | |||||||||
| NPI: | 1801058896 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LUGO | ||||||||
| FirstName: | ALISON | ||||||||
| MiddleName: | ANN | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | B.S. | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | EMMIL | ||||||||
| OtherFirstName: | ALISON | ||||||||
| OtherMiddleName: | ANN | ||||||||
| OtherNamePrefix: | |||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | B.S. | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 822 W TOWN AND COUNTRY RD | ||||||||
| Address2: | |||||||||
| City: | ORANGE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 928684712 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7145477559 | ||||||||
| FaxNumber: | 7145434431 | ||||||||
| Practice Location | |||||||||
| Address1: | 2416 S MAIN ST | ||||||||
| Address2: | SUITE B | ||||||||
| City: | SANTA ANA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 927073290 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7149669999 | ||||||||
| FaxNumber: | 7149669996 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/30/2008 | ||||||||
| LastUpdateDate: | 06/30/2008 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | |||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101Y00000X | CA | Y | Behavioral Health & Social Service Providers | Counselor |
No ID Information.