Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101Y00000X | Counselor | ||
Y | 106S00000X | Behavior Technician |
NPI | 1003281783 |
---|---|
Provider Name | Michael Lozano |
First Address | Irvine, CA 92606-2417 |
Second Address | Chula Vista, CA 91910 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/12/2015 |
Last Update Date | 10/04/2019 |