Individual provider Active NPI

Sandra Lujan, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • San Francisco, CA
National Provider Identifier
1740979830
Registry record updated May 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
95029638 Issued in CA
Practice address
520B Lombard St
San Francisco, CA 94133-7057
Phone
(619) 639-9730
NPI assigned
May 3, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 1117206 TX
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 95029638 CA Primary

Addresses

Primary practice location

520B Lombard St
San Francisco, CA 94133-7057

Mailing address

755 Wappenbury Rd
El Paso, TX 79928-6307
Phone (915) 504-5090

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, CA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240501000417 TX Practitioner - Nurse Practitioner 4385084847
I20240605000687 CA Practitioner - Nurse Practitioner 4385084847 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mood Clinical, P. C.Group PAC ID 4981080769, 107 clinicians

Practice addresses (Care Compare)

18191 Von Karman Ave
Suite 100
Irvine, CA 92612-7103
Phone (619) 639-9730

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95029638CAMDPsychiatric/Mental Health Nurse Practitioner
1117206TXMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mood Clinical, P. C. Psychiatric/Mental Health CurrentSince Apr 23, 2024 Accepting new patients
Glenn Medical Center, LLC PastSince Apr 23, 2024 Accepting new patients
Horizons Behavioral Health LLC PastSince Oct 20, 2024 Accepting new patients

Locations

18191 Von Karman Ave
Ste 100
Irvine, CA 92612
Phone (530) 889-7293

50 California St
Ste 1500
San Francisco, CA 94111
Phone (310) 648-0700

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1683072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715040000000",
    "number": "1740979830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "755 WAPPENBURY RD",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799286307",
            "telephone_number": "915-504-5090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520B LOMBARD ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941337057",
            "telephone_number": "619-639-9730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUJAN",
        "first_name": "SANDRA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-03",
        "last_updated": "2024-05-07",
        "certification_date": "2024-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "1117206",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95029638",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

Verify at the official NPI Registry.