Provider Demographics
NPI:1306032156
Name:LOPEZ TILEY, ADRIENNE CLAIRE (MA)
Entity Type:Individual
Prefix:
First Name:ADRIENNE
Middle Name:CLAIRE
Last Name:LOPEZ TILEY
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:ADRIENNE
Other - Middle Name:CLAIRE
Other - Last Name:LOPEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:401 ROLAND WAY SUITE 100
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94621
Mailing Address - Country:US
Mailing Address - Phone:510-746-2800
Mailing Address - Fax:510-746-2810
Practice Address - Street 1:401 ROLAND WAY SUITE 100
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94621
Practice Address - Country:US
Practice Address - Phone:510-746-2800
Practice Address - Fax:510-746-2810
Is Sole Proprietor?:No
Enumeration Date:2007-09-14
Last Update Date:2020-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health