Healthcare Provider Details

I. General information

NPI: 1881942407
Provider Name (Legal Business Name): NATALIA IRASEMA LUNA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/29/2012
Last Update Date: 12/12/2024
Certification Date: 12/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

52 W CORRELL RD
HEBER CA
92249-9644
US

IV. Provider business mailing address

52 W CORRELL RD
HEBER CA
92249-9644
US

V. Phone/Fax

Practice location:
  • Phone: 442-367-6659
  • Fax:
Mailing address:
  • Phone: 760-562-4010
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number85979
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: