Healthcare Provider Details

I. General information

NPI: 1205507852
Provider Name (Legal Business Name): MARIA DE LOS ANGELES LUEVANO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/23/2021
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 PACIFIC ST
MONTEREY CA
93940-2864
US

IV. Provider business mailing address

700 PACIFIC ST
MONTEREY CA
93940-2864
US

V. Phone/Fax

Practice location:
  • Phone: 831-272-5351
  • Fax:
Mailing address:
  • Phone: 831-645-1200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: