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Organization
LUMINOUS MIND MEDICINE INC.
Active
Organization
LUMINOUS MIND MEDICINE INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VIOLETA REYES (RN-COORDINATOR)
(510) 480-8521
Entity
Organization
Contact information
Practice address
411 30TH ST STE 502, OAKLAND, CA 94609-3300
(510) 480-8521
Mailing address
411 30TH ST STE 502, OAKLAND, CA 94609-3300
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Enumeration date
09/07/2021
Last updated
01/05/2022
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