Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YA0400X | Addiction Counselor (Substance Use Disorder) |
NPI | 1003198979 |
---|---|
Provider Name | Silvia Elena Lopez |
First Address | Marina, CA 93933-4024 |
Second Address | Salinas, CA 93901-2323 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/09/2011 |
Last Update Date | 15/09/2011 |