Provider Demographics
NPI:1750460853
Name:LOPEZ, MARCELLA JOSEFINA
Entity Type:Individual
Prefix:MS
First Name:MARCELLA
Middle Name:JOSEFINA
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 1:1417 BATH ST APT D
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93101-6666
Mailing Address - Country:US
Mailing Address - Phone:805-964-2347
Mailing Address - Fax:805-964-7079
Practice Address - Street 1:5681 HOLLISTER AVE
Practice Address - Street 2:
Practice Address - City:GOLETA
Practice Address - State:CA
Practice Address - Zip Code:93117-3488
Practice Address - Country:US
Practice Address - Phone:805-964-2347
Practice Address - Fax:805-964-7079
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator