| Luminarias Institute Inc. | |
|
601 S Brand Blvd Ste 101 San Fernando CA 91340-4060 | |
| (818) 898-9493 | |
| Not Available |
| Full Name | Luminarias Institute Inc. |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 601 S Brand Blvd Ste 101, San Fernando, California |
| Authorized Official Name and Position | Jose Cardenas (PRESIDENT) |
| Authorized Official Contact | 8188989493 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Luminarias Institute Inc. 601 S Brand Blvd Ste 110 San Fernando CA 91340-4060 Ph: (818) 898-9493 | Luminarias Institute Inc. 601 S Brand Blvd Ste 101 San Fernando CA 91340-4060 Ph: (818) 898-9493 |
| NPI Number | 1679936975 |
|---|---|
| Provider Enumeration Date | 04/04/2016 |
| Last Update Date | 04/08/2016 |
| Medicare PECOS PAC ID | 9234670258 |
|---|---|
| Medicare Enrollment ID | O20240918001334 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679936975 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | PSY10436 (California) | Primary |
| Provider Name | Jose Cardenas |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1639295397 PECOS PAC ID: 7012135973 Enrollment ID: I20241021003833 |
| Provider Name | Nahil Dawud |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1427202100 PECOS PAC ID: 4981139243 Enrollment ID: I20241122001834 |
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