Healthcare Provider Details

I. General information

NPI: 1497659478
Provider Name (Legal Business Name): LUMI PSYCHOLOGICAL SERVICES, PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2026
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

383 CAMELLIA WAY
VACAVILLE CA
95688-4312
US

IV. Provider business mailing address

383 CAMELLIA WAY
VACAVILLE CA
95688-4312
US

V. Phone/Fax

Practice location:
  • Phone: 510-300-5648
  • Fax:
Mailing address:
  • Phone: 510-300-5648
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number StateNULL

VIII. Authorized Official

Name: DR. FAAFETAI FAALEAVA
Title or Position: PRESIDENT/CEO
Credential: PSY.D.
Phone: 510-300-5648