Healthcare Provider Details

I. General information

NPI: 1215859210
Provider Name (Legal Business Name): MARIBEL LUNA PEREZ LVN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/29/2026
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25971 MAR VISTA CT
LOS GATOS CA
95033-8026
US

IV. Provider business mailing address

2500 SOQUEL DR APT L14
SANTA CRUZ CA
95065-1934
US

V. Phone/Fax

Practice location:
  • Phone: 877-359-5450
  • Fax:
Mailing address:
  • Phone: 916-279-6511
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164X00000X
TaxonomyLicensed Vocational Nurse
License NumberVN760638
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: