Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YA0400X | Addiction Counselor (Substance Use Disorder) |
NPI | 1003057480 |
---|---|
Provider Name | Elizabeth Lopez |
First Address | Santa Paula, CA 93060-2144 |
Second Address | Santa Paula, CA 93060-2144 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/03/2009 |
Last Update Date | 16/03/2009 |