Healthcare Provider Details

I. General information

NPI: 1255011409
Provider Name (Legal Business Name): LUNA'S CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/21/2023
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2384 E MAIN ST
STOCKTON CA
95205-6552
US

IV. Provider business mailing address

2384 E MAIN ST
STOCKTON CA
95205-6552
US

V. Phone/Fax

Practice location:
  • Phone: 209-370-3726
  • Fax:
Mailing address:
  • Phone: 209-370-3726
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: ANA R ORTIZ SANROMAN
Title or Position: ONWER
Credential: N/A
Phone: 209-370-3726