Provider Demographics
NPI:1518625110
Name:LOPEZ, MONICA B (MA)
Entity Type:Individual
Prefix:MS
First Name:MONICA
Middle Name:B
Last Name:LOPEZ
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3317 W BEVERLY BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:MONTEBELLO
Mailing Address - State:CA
Mailing Address - Zip Code:90640-1572
Mailing Address - Country:US
Mailing Address - Phone:323-621-6700
Mailing Address - Fax:562-699-1502
Practice Address - Street 1:3317 W BEVERLY BLVD STE 200
Practice Address - Street 2:
Practice Address - City:MONTEBELLO
Practice Address - State:CA
Practice Address - Zip Code:90640-1572
Practice Address - Country:US
Practice Address - Phone:323-621-6700
Practice Address - Fax:562-699-1502
Is Sole Proprietor?:No
Enumeration Date:2021-12-01
Last Update Date:2021-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1744R1102XOther Service ProvidersSpecialistResearch Study