Provider Demographics
NPI:1689322208
Name:LOZANO, LUIS
Entity Type:Individual
Prefix:MR
First Name:LUIS
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 1:7209 TOLER AVE
Mailing Address - Street 2:
Mailing Address - City:BELL GARDENS
Mailing Address - State:CA
Mailing Address - Zip Code:90201-4733
Mailing Address - Country:US
Mailing Address - Phone:562-417-7630
Mailing Address - Fax:
Practice Address - Street 1:7209 TOLER AVE
Practice Address - Street 2:
Practice Address - City:BELL GARDENS
Practice Address - State:CA
Practice Address - Zip Code:90201-4733
Practice Address - Country:US
Practice Address - Phone:562-417-7630
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-13
Last Update Date:2022-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst