Healthcare Provider Details

I. General information

NPI: 1477425452
Provider Name (Legal Business Name): TAMI LUNA CADC II
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/19/2025
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40700 CALIFORNIA OAKS RD STE 202
MURRIETA CA
92562-5789
US

IV. Provider business mailing address

40700 CALIFORNIA OAKS RD STE 202
MURRIETA CA
92562-5789
US

V. Phone/Fax

Practice location:
  • Phone: 951-477-6591
  • Fax: 951-477-6591
Mailing address:
  • Phone:
  • Fax: 951-477-6591

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberA063150823
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: