Provider Demographics
NPI:1841619491
Name:EISENBREY, LUANA
Entity Type:Individual
Prefix:
First Name:LUANA
Middle Name:
Last Name:EISENBREY
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 1:1615 E 17TH ST
Mailing Address - Street 2:100
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92705-8529
Mailing Address - Country:US
Mailing Address - Phone:714-559-9420
Mailing Address - Fax:
Practice Address - Street 1:1615 E 17TH ST
Practice Address - Street 2:100
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92705-8529
Practice Address - Country:US
Practice Address - Phone:714-559-9420
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-10
Last Update Date:2014-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor