Provider Demographics
NPI:1750556858
Name:LUJAN, NADINE (MS)
Entity type:Individual
Prefix:MS
First Name:NADINE
Middle Name:
Last Name:LUJAN
Suffix:
Gender:F
Credentials:MS
Other - Prefix:MS
Other - First Name:NADINE
Other - Middle Name:
Other - Last Name:LUJAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2800 CAMINO DOS RIOS
Mailing Address - Street 2:SUITE 101-A
Mailing Address - City:NEWBURY PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91320
Mailing Address - Country:US
Mailing Address - Phone:805-273-8779
Mailing Address - Fax:
Practice Address - Street 1:2800 CAMINO DOS RIOS
Practice Address - Street 2:SUITE 101-A
Practice Address - City:NEWBURY PARK
Practice Address - State:CA
Practice Address - Zip Code:91320
Practice Address - Country:US
Practice Address - Phone:805-738-8779
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-29
Last Update Date:2022-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
CA81255101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health