Provider Demographics
NPI:1083358527
Name:LUNA COUNSELING; INDIVIDUAL, COUPLES AND FAMILY THERAPY A PROFESSIONAL
Entity Type:Organization
Organization Name:LUNA COUNSELING; INDIVIDUAL, COUPLES AND FAMILY THERAPY A PROFESSIONAL
Other - Org Name:LUNA COUNSELING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:VIRIDIANA
Authorized Official - Middle Name:LUNA
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:949-732-0252
Mailing Address - Street 1:1000 S FREMONT AVE STE A0207
Mailing Address - Street 2:
Mailing Address - City:ALHAMBRA
Mailing Address - State:CA
Mailing Address - Zip Code:91803-8800
Mailing Address - Country:US
Mailing Address - Phone:831-578-3440
Mailing Address - Fax:
Practice Address - Street 1:1000 S FREMONT AVE STE A0207
Practice Address - Street 2:
Practice Address - City:ALHAMBRA
Practice Address - State:CA
Practice Address - Zip Code:91803-8800
Practice Address - Country:US
Practice Address - Phone:949-732-0252
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-21
Last Update Date:2023-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1013342559OtherNPI
CA109604OtherLMFT