Provider Demographics
NPI:1821594573
Name:LOPEZ, LORI ANN (CCAPP)
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:ANN
Last Name:LOPEZ
Suffix:
Gender:F
Credentials:CCAPP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13218 AVALON BLVD APT 309
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90061-2364
Mailing Address - Country:US
Mailing Address - Phone:562-361-0952
Mailing Address - Fax:
Practice Address - Street 1:13218 AVALON BLVD APT 309
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90061-2364
Practice Address - Country:US
Practice Address - Phone:562-428-4111
Practice Address - Fax:562-984-5610
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-02
Last Update Date:2018-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor