Healthcare Provider Details

I. General information

NPI: 1295414738
Provider Name (Legal Business Name): LUNAI WELLNESS CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/12/2023
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10717 CAMINO RUIZ STE 134
SAN DIEGO CA
92126-2362
US

IV. Provider business mailing address

10717 CAMINO RUIZ STE 134
SAN DIEGO CA
92126-2362
US

V. Phone/Fax

Practice location:
  • Phone: 858-465-0665
  • Fax: 877-647-9913
Mailing address:
  • Phone: 858-465-0665
  • Fax: 877-647-9913

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State

VIII. Authorized Official

Name: ALYSSA ELLA DEGUZMAN
Title or Position: DOCTOR
Credential:
Phone: 858-465-0665