Provider Demographics
NPI:1881853661
Name:LOPEZ, AMY CHOATE (LCSW 75746)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:CHOATE
Last Name:LOPEZ
Suffix:
Gender:F
Credentials:LCSW 75746
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:LOUISE
Other - Last Name:CHOATE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:950 W JULIAN ST
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95126-2719
Mailing Address - Country:US
Mailing Address - Phone:408-977-1950
Mailing Address - Fax:
Practice Address - Street 1:251 LLEWELLYN AVE
Practice Address - Street 2:
Practice Address - City:CAMPBELL
Practice Address - State:CA
Practice Address - Zip Code:95008-1940
Practice Address - Country:US
Practice Address - Phone:408-379-3790
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-05
Last Update Date:2022-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA757461041C0700X
CAASW333061041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical