Provider Demographics
NPI:1639460728
Name:LOPES, TERESA (AA COUNSELING)
Entity Type:Individual
Prefix:MS
First Name:TERESA
Middle Name:
Last Name:LOPES
Suffix:
Gender:F
Credentials:AA COUNSELING
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:555 S SOTO ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90033-4317
Mailing Address - Country:US
Mailing Address - Phone:323-247-1348
Mailing Address - Fax:
Practice Address - Street 1:431 W COMPTON BLVD
Practice Address - Street 2:
Practice Address - City:COMPTON
Practice Address - State:CA
Practice Address - Zip Code:90220-3008
Practice Address - Country:US
Practice Address - Phone:323-247-1348
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-25
Last Update Date:2011-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)