Provider Demographics
NPI:1023565595
Name:LUA, SERGIO ARTURO (MA LMFT)
Entity Type:Individual
Prefix:MR
First Name:SERGIO
Middle Name:ARTURO
Last Name:LUA
Suffix:
Gender:M
Credentials:MA LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 CABRILLO HWY S STE 200A
Mailing Address - Street 2:
Mailing Address - City:HALF MOON BAY
Mailing Address - State:CA
Mailing Address - Zip Code:94019-7210
Mailing Address - Country:US
Mailing Address - Phone:650-726-6369
Mailing Address - Fax:
Practice Address - Street 1:225 CABRILLO HWY S
Practice Address - Street 2:
Practice Address - City:HALF MOON BAY
Practice Address - State:CA
Practice Address - Zip Code:94019-8200
Practice Address - Country:US
Practice Address - Phone:650-726-6369
Practice Address - Fax:650-726-4963
Is Sole Proprietor?:No
Enumeration Date:2016-09-01
Last Update Date:2022-06-07
Deactivation Date:2018-08-06
Deactivation Code:
Reactivation Date:2018-08-15
Provider Licenses
StateLicense IDTaxonomies
CA172V00000X
106H00000X, 390200000X
CA132989106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No172V00000XOther Service ProvidersCommunity Health Worker
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program