Healthcare Provider Details

I. General information

NPI: 1245881069
Provider Name (Legal Business Name): ERIKA M LUNA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/23/2019
Last Update Date: 09/23/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1405 SPRUCE ST STE A
RIVERSIDE CA
92507-2410
US

IV. Provider business mailing address

1405 SPRUCE ST STE A
RIVERSIDE CA
92507-2410
US

V. Phone/Fax

Practice location:
  • Phone: 951-955-8206
  • Fax: 951-784-4986
Mailing address:
  • Phone: 951-955-8206
  • Fax: 951-784-4986

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: