Healthcare Provider Details

I. General information

NPI: 1588532097
Provider Name (Legal Business Name): MARIBEL LUNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/27/2025
Last Update Date: 10/27/2025
Certification Date: 10/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

615 S ATWOOD ST
VISALIA CA
93277-8302
US

IV. Provider business mailing address

615 S ATWOOD ST
VISALIA CA
93277-8302
US

V. Phone/Fax

Practice location:
  • Phone: 559-732-8086
  • Fax:
Mailing address:
  • Phone: 559-732-8086
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164X00000X
TaxonomyLicensed Vocational Nurse
License Number719261
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: