Provider Demographics
NPI:1821619677
Name:ALUNA HEALTHCARE
Entity Type:Organization
Organization Name:ALUNA HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:MCINTOSH
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L, OTD
Authorized Official - Phone:561-762-8768
Mailing Address - Street 1:1640 VALENCIA ST STE 2A3
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94110-5047
Mailing Address - Country:US
Mailing Address - Phone:561-762-8768
Mailing Address - Fax:
Practice Address - Street 1:1640 VALENCIA ST STE 2A3
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110-5047
Practice Address - Country:US
Practice Address - Phone:561-762-8768
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-04
Last Update Date:2020-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1003447715Medicaid