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General NPI Number Information
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NPI Number | 1831083419
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Entity Type | Organization
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Legal Business Name | LUMA BEHAVIORAL
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Dates
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Enumeration Date | 06/06/2025
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Last Update Date | 07/29/2025
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Provider Practice Location Address
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Address Line | 3755 BEVERLY BLVD STE 301
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City | LOS ANGELES
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State | CA
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Zip | 90004-3540
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Country | US
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Telephone | 424-507-4544
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Fax |
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Provider Business Mailing Address
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Address Line | 3755 BEVERLY BLVD STE 301
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City | LOS ANGELES
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State | CA
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Zip | 90004-3540
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Country | US
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Telephone | 424-507-4544
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | OLENA TIULKINA
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Credential |
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Telephone | 424-507-4544
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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