Provider Demographics
NPI:1871864660
Name:LOPEZ, ALBERTO (LCSW)
Entity Type:Individual
Prefix:DR
First Name:ALBERTO
Middle Name:
Last Name:LOPEZ
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6835 KESTER AVE APT 7
Mailing Address - Street 2:
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91405-3719
Mailing Address - Country:US
Mailing Address - Phone:818-723-1869
Mailing Address - Fax:
Practice Address - Street 1:9535 RESEDA BLVD STE 112
Practice Address - Street 2:
Practice Address - City:NORTHRIDGE
Practice Address - State:CA
Practice Address - Zip Code:91324-6022
Practice Address - Country:US
Practice Address - Phone:818-643-1044
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-25
Last Update Date:2021-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCSW968911041C0700X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical