Provider Demographics
NPI:1144720012
Name:LUNA, LAURA LILIANA (PHD)
Entity type:Individual
Prefix:DR
First Name:LAURA
Middle Name:LILIANA
Last Name:LUNA
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 175
Mailing Address - Street 2:
Mailing Address - City:YORBA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92885-0175
Mailing Address - Country:US
Mailing Address - Phone:909-648-8407
Mailing Address - Fax:
Practice Address - Street 1:115 PINE AVE STE 440
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90802-4465
Practice Address - Country:US
Practice Address - Phone:562-349-3032
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-17
Last Update Date:2018-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist