Healthcare Provider Details

I. General information

NPI: 1356713663
Provider Name (Legal Business Name): EVA ALICIA LUVIANO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/26/2015
Last Update Date: 04/30/2025
Certification Date: 04/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1609 E PALMDALE BLVD SUITE G
PALMDALE CA
93550
US

IV. Provider business mailing address

44720 RODIN AVE
LANCASTER CA
93535-3110
US

V. Phone/Fax

Practice location:
  • Phone: 661-947-1595
  • Fax: 661-272-0415
Mailing address:
  • Phone: 661-733-7221
  • Fax: 661-272-0415

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code373H00000X
TaxonomyDay Training/Habilitation Specialist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: