Provider Demographics
NPI:1285857565
Name:LOZANO, GILBERT
Entity Type:Individual
Prefix:MR
First Name:GILBERT
Middle Name:
Last Name:LOZANO
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 1:7101 BAIRD AVE
Mailing Address - Street 2:101
Mailing Address - City:RESEDA
Mailing Address - State:CA
Mailing Address - Zip Code:91335-4150
Mailing Address - Country:US
Mailing Address - Phone:818-342-5897
Mailing Address - Fax:818-345-6256
Practice Address - Street 1:7101 BAIRD AVE
Practice Address - Street 2:101
Practice Address - City:RESEDA
Practice Address - State:CA
Practice Address - Zip Code:91335-4150
Practice Address - Country:US
Practice Address - Phone:818-342-5897
Practice Address - Fax:818-345-6256
Is Sole Proprietor?:No
Enumeration Date:2007-04-11
Last Update Date:2014-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARI-L1006072051101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)