Luminous Mind Medicine Inc.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

Legal business name

LUMINOUS MIND MEDICINE INC.

Practice address

411 30TH St Ste 502
Oakland, CA 94609-3300

Phone

(510) 480-8521

NPI assigned

Sep 7, 2021

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Violeta Reyes

Title

RN-Coordinator

Phone

(510) 480-8521

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1630972800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1641340800000",
    "number": "1699444380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 30TH ST STE 502",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946093300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 30TH ST STE 502",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946093300",
            "telephone_number": "510-480-8521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUMINOUS MIND MEDICINE INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-07",
        "last_updated": "2022-01-05",
        "certification_date": "2022-01-05",
        "status": "A",
        "authorized_official_last_name": "REYES",
        "authorized_official_first_name": "VIOLETA",
        "authorized_official_title_or_position": "RN-COORDINATOR",
        "authorized_official_telephone_number": "510-480-8521"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rosemary Elizabeth Lum-Levine, SOCIAL WORKER
• Brian K Lum, PHARM.D.
• Caryn Lum, MD
• Kristen Lum, MD
• Charles Deleon Lumboy, NP
• Camille Lumsden, M.S., PPSC
• Tamentanefer Lumukanda, IBCLC
• Jessica Rene Luna-Oliver, RN
• Alexine A Luna
• Angela Krishna Luna, LMFT, M.A., J.D.

• Psychiatry Physician in Oakland, CA
• Providers in Oakland, CA by specialty
• Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.