Individual
MR. JEREMY LUENA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
COTA/L
Contact information
Practice address
4650 HOEN AVE, SANTA ROSA, CA 95405-9407
(707) 546-0471
Mailing address
910 KAY AVE, TRINIDAD, CA 95570-9727
(860) 301-4739
Taxonomy
Speciality
Code
Description
License number
State
225XP0019X
Physical Rehabilitation Occupational Therapist
Primary
5317
CA
Other
Enumeration date
08/07/2021
Last updated
08/07/2021
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