Healthcare Provider Details

I. General information

NPI: 1831926104
Provider Name (Legal Business Name): EMILY LOUKA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/19/2024
Last Update Date: 05/27/2025
Certification Date: 09/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24502 PACIFIC PARK DR
ALISO VIEJO CA
92656-3033
US

IV. Provider business mailing address

1901 E DYER RD UNIT 425
SANTA ANA CA
92705-5789
US

V. Phone/Fax

Practice location:
  • Phone: 714-644-6480
  • Fax:
Mailing address:
  • Phone: 909-725-2369
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number149175
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: