Provider Demographics
NPI:1316511504
Name:LUNA COUNSELING MARRIAGE AND FAMILY THERAPY INC
Entity type:Organization
Organization Name:LUNA COUNSELING MARRIAGE AND FAMILY THERAPY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/ LICENSED THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:GUADALUPE
Authorized Official - Middle Name:M
Authorized Official - Last Name:NAMBO
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:916-237-7457
Mailing Address - Street 1:333 UNIVERSITY AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95825-6540
Mailing Address - Country:US
Mailing Address - Phone:916-237-7457
Mailing Address - Fax:
Practice Address - Street 1:333 UNIVERSITY AVE STE 200
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95825-6540
Practice Address - Country:US
Practice Address - Phone:916-237-7457
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-13
Last Update Date:2021-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty