Provider Demographics
NPI:1184871865
Name:LUNA DIAZ, LILIANA MONSERRAT
Entity type:Individual
Prefix:
First Name:LILIANA
Middle Name:MONSERRAT
Last Name:LUNA DIAZ
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 1:1400 S UNION AVE
Mailing Address - Street 2:STE 100
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93307-4179
Mailing Address - Country:US
Mailing Address - Phone:661-397-8775
Mailing Address - Fax:661-397-8282
Practice Address - Street 1:8787 HALL RD
Practice Address - Street 2:CSV-ADULT BEHAVIORAL HEALTH CENTER
Practice Address - City:LAMONT
Practice Address - State:CA
Practice Address - Zip Code:93241-1953
Practice Address - Country:US
Practice Address - Phone:661-845-3717
Practice Address - Fax:661-845-3385
Is Sole Proprietor?:No
Enumeration Date:2008-08-25
Last Update Date:2014-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAASW 634251041C0700X
171M00000X, 390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program