Provider Demographics
NPI:1750038188
Name:LOPEZ, ROSAMARIA L
Entity Type:Individual
Prefix:
First Name:ROSAMARIA
Middle Name:L
Last Name:LOPEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32988 ROAD 160
Mailing Address - Street 2:
Mailing Address - City:IVANHOE
Mailing Address - State:CA
Mailing Address - Zip Code:93235-1306
Mailing Address - Country:US
Mailing Address - Phone:559-736-6380
Mailing Address - Fax:
Practice Address - Street 1:1798 BRYMAN ST
Practice Address - Street 2:
Practice Address - City:HANFORD
Practice Address - State:CA
Practice Address - Zip Code:93230-7144
Practice Address - Country:US
Practice Address - Phone:559-736-6380
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-06
Last Update Date:2022-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical