Provider Demographics
NPI:1053208884
Name:LOPEZ, ANABERTA
Entity type:Individual
Prefix:
First Name:ANABERTA
Middle Name:
Last Name:LOPEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:955 1/2 W 42ND ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90037-2393
Mailing Address - Country:US
Mailing Address - Phone:213-446-5711
Mailing Address - Fax:
Practice Address - Street 1:237 N CENTRAL AVE STE A
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91203-3526
Practice Address - Country:US
Practice Address - Phone:661-360-6300
Practice Address - Fax:661-360-6301
Is Sole Proprietor?:No
Enumeration Date:2025-06-23
Last Update Date:2025-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician