Provider Demographics
NPI:1376835009
Name:LOPEZ, EMILIANO RAMIREZ (CARE COORDINATOR)
Entity Type:Individual
Prefix:MR
First Name:EMILIANO
Middle Name:RAMIREZ
Last Name:LOPEZ
Suffix:
Gender:M
Credentials:CARE COORDINATOR
Other - Prefix:
Other - First Name:EMILIANO
Other - Middle Name:
Other - Last Name:LOPEZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CARE COORDINAOR
Mailing Address - Street 1:1125 W 6TH ST
Mailing Address - Street 2:SUITE 103
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90017-1833
Mailing Address - Country:US
Mailing Address - Phone:213-241-0979
Mailing Address - Fax:213-202-3977
Practice Address - Street 1:1125 W 6TH ST
Practice Address - Street 2:SUITE 103
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90017-1833
Practice Address - Country:US
Practice Address - Phone:213-241-0979
Practice Address - Fax:213-202-3977
Is Sole Proprietor?:No
Enumeration Date:2011-05-13
Last Update Date:2011-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health