Provider Demographics
NPI:1164701165
Name:LOPEZ-BOPP, DANIELLE M (MFT)
Entity Type:Individual
Prefix:MS
First Name:DANIELLE
Middle Name:M
Last Name:LOPEZ-BOPP
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27715 JEFFERSON AVE STE 112
Mailing Address - Street 2:
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92590-6601
Mailing Address - Country:US
Mailing Address - Phone:951-288-6835
Mailing Address - Fax:
Practice Address - Street 1:27715 JEFFERSON AVE STE 112
Practice Address - Street 2:
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92590-6601
Practice Address - Country:US
Practice Address - Phone:951-288-6835
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-08
Last Update Date:2011-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC37609106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist