Provider Demographics
NPI:1245408475
Name:LOPEZ, FLORNESTO B (RN)
Entity Type:Individual
Prefix:MR
First Name:FLORNESTO
Middle Name:B
Last Name:LOPEZ
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:816 BAKER ST
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93305-5213
Mailing Address - Country:US
Mailing Address - Phone:661-327-9376
Mailing Address - Fax:661-327-7649
Practice Address - Street 1:816 BAKER ST
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93305-5213
Practice Address - Country:US
Practice Address - Phone:661-327-9376
Practice Address - Fax:661-327-7649
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-11
Last Update Date:2008-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health