Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 25189 | CA |
Y | 103TC0700X | Clinical Psychologist | 25189 | CA |
N | 103TH0100X | Health Service | 25189 | CA |
NPI | 1215196217 |
---|---|
Provider Name | Dr. Jesus Javier Luna |
First Address | Winters, CA 95694-1722 |
Second Address | Winters, CA 95694-1722 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/06/2008 |
Last Update Date | 25/02/2013 |