Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101Y00000X | Counselor |
NPI | 1003357419 |
---|---|
Provider Name | Alma Lopez |
First Address | Exeter, CA 93221-2306 |
Second Address | Exeter, CA 93221-2306 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/03/2017 |
Last Update Date | 17/03/2017 |