Provider Demographics
NPI:1598554685
Name:FLYNN, LUNA CASSANDRA (ME - PPS SCH COUN)
Entity type:Individual
Prefix:
First Name:LUNA
Middle Name:CASSANDRA
Last Name:FLYNN
Suffix:
Gender:
Credentials:ME - PPS SCH COUN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24680 COUNTY ROAD 101A
Mailing Address - Street 2:
Mailing Address - City:DAVIS
Mailing Address - State:CA
Mailing Address - Zip Code:95616-9409
Mailing Address - Country:US
Mailing Address - Phone:925-322-9378
Mailing Address - Fax:
Practice Address - Street 1:1441 DANBURY ST
Practice Address - Street 2:
Practice Address - City:DAVIS
Practice Address - State:CA
Practice Address - Zip Code:95618-4892
Practice Address - Country:US
Practice Address - Phone:530-759-2100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-05
Last Update Date:2025-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA230212639101YS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool