Provider Demographics
NPI:1629749023
Name:LUNA, ELIZABETH EMILY
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:EMILY
Last Name:LUNA
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 1:3630 N LOS COYOTES DIAGONAL
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90808-2406
Mailing Address - Country:US
Mailing Address - Phone:562-786-7392
Mailing Address - Fax:
Practice Address - Street 1:3630 N LOS COYOTES DIAGONAL
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90808-2406
Practice Address - Country:US
Practice Address - Phone:562-786-7392
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-24
Last Update Date:2021-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician