Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225C00000X | Rehabilitation Counselor |
NPI | 1023361227 |
---|---|
Provider Name | Maritza Lopez |
First Address | Escondido, CA 92025-6428 |
Second Address | Oceanside, CA 92056-4565 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/10/2012 |
Last Update Date | 15/11/2019 |