Provider Demographics
NPI:1750598595
Name:LUNA, VANESSA DAWN
Entity type:Individual
Prefix:
First Name:VANESSA
Middle Name:DAWN
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 1:1957 SEVILLE DR
Mailing Address - Street 2:
Mailing Address - City:NAPA
Mailing Address - State:CA
Mailing Address - Zip Code:94559-4320
Mailing Address - Country:US
Mailing Address - Phone:707-337-2561
Mailing Address - Fax:
Practice Address - Street 1:1957 SEVILLE DR
Practice Address - Street 2:
Practice Address - City:NAPA
Practice Address - State:CA
Practice Address - Zip Code:94559-4320
Practice Address - Country:US
Practice Address - Phone:707-337-2561
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA39020000XOtherSTUDENT