Healthcare Provider Details

I. General information

NPI: 1861067795
Provider Name (Legal Business Name): LUNA GRACE ADRIENNE ARENAS-FIELD BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/24/2021
Last Update Date: 11/27/2023
Certification Date: 11/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2820 CAMINO DEL RIO S STE 100
SAN DIEGO CA
92108-3822
US

IV. Provider business mailing address

7233 PURDUE AVE
LA MESA CA
91942-5919
US

V. Phone/Fax

Practice location:
  • Phone: 858-264-5858
  • Fax: 858-649-6012
Mailing address:
  • Phone: 442-202-9093
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: