Provider Demographics
NPI:1083742001
Name:LOPEZ, NORBERTO
Entity Type:Individual
Prefix:MR
First Name:NORBERTO
Middle Name:
Last Name:LOPEZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13838 ANADA ST
Mailing Address - Street 2:
Mailing Address - City:BALDWIN PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91706-1407
Mailing Address - Country:US
Mailing Address - Phone:626-960-7807
Mailing Address - Fax:951-274-9865
Practice Address - Street 1:1777 ATLANTA AVE STE G1
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92507-7417
Practice Address - Country:US
Practice Address - Phone:951-778-3500
Practice Address - Fax:951-274-9865
Is Sole Proprietor?:No
Enumeration Date:2007-03-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)