Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101Y00000X | Counselor | ||
N | 101YM0800X | Mental Health Counselor | 86522 | CA |
Y | 104100000X | Social Worker | 86522 | CA |
NPI | 1003384637 |
---|---|
Provider Name | Cynthia Lopez |
First Address | King City, CA 93930-3602 |
Second Address | King City, CA 93930-3602 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/11/2018 |
Last Update Date | 19/03/2019 |