Provider Demographics
NPI:1871254177
Name:LOPEZ, YECENIA VERONICA (DC)
Entity Type:Individual
Prefix:DR
First Name:YECENIA
Middle Name:VERONICA
Last Name:LOPEZ
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1240 MONUMENT BLVD APT I1
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94520-4434
Mailing Address - Country:US
Mailing Address - Phone:951-867-0424
Mailing Address - Fax:
Practice Address - Street 1:1708 PARK ST STE 130
Practice Address - Street 2:
Practice Address - City:ALAMEDA
Practice Address - State:CA
Practice Address - Zip Code:94501-1998
Practice Address - Country:US
Practice Address - Phone:510-769-0125
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-07
Last Update Date:2022-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA35000111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor