Provider Demographics
NPI:1144317645
Name:HARRIS-LUNA, MARCIA LEONORA (FNP/PNP)
Entity type:Individual
Prefix:MRS
First Name:MARCIA
Middle Name:LEONORA
Last Name:HARRIS-LUNA
Suffix:
Gender:F
Credentials:FNP/PNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23181 VERDUGO DR STE 103A
Mailing Address - Street 2:HOUSECALL DOCTORS MEDICAL GROUP, INC.
Mailing Address - City:LAGUNA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:92653-1313
Mailing Address - Country:US
Mailing Address - Phone:949-366-1053
Mailing Address - Fax:
Practice Address - Street 1:23181 VERDUGO DR
Practice Address - Street 2:
Practice Address - City:LAGUNA HILLS
Practice Address - State:CA
Practice Address - Zip Code:92653-1357
Practice Address - Country:US
Practice Address - Phone:949-366-1053
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2021-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANPF9983363LP0200X
CANPFL 9983363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CANP0099830Medicaid
CAWNP9983AMedicare ID - Type Unspecified