Provider Demographics
NPI:1235836198
Name:LUJAN, MARINA
Entity Type:Individual
Prefix:
First Name:MARINA
Middle Name:
Last Name:LUJAN
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 1:325 E HILLCREST DR STE 115
Mailing Address - Street 2:
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91360-7782
Mailing Address - Country:US
Mailing Address - Phone:818-851-0020
Mailing Address - Fax:
Practice Address - Street 1:325 E HILLCREST DR STE 115
Practice Address - Street 2:
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91360-7782
Practice Address - Country:US
Practice Address - Phone:818-851-0020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-10
Last Update Date:2023-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist