Healthcare Provider Details

I. General information

NPI: 1144156241
Provider Name (Legal Business Name): LUMINARIAS PSYCHOLOGICAL SERVICES, A PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2026
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 S BRAND BLVD STE 110
SAN FERNANDO CA
91340-4039
US

IV. Provider business mailing address

601 S BRAND BLVD STE 110
SAN FERNANDO CA
91340-4039
US

V. Phone/Fax

Practice location:
  • Phone: 818-714-2275
  • Fax:
Mailing address:
  • Phone: 818-714-2275
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: JOSE CARDENAS
Title or Position: OWNER
Credential: PSYD
Phone: 818-314-8358