Provider Demographics
NPI:1912391020
Name:LOPEZ-MOYA, ADRIANA PAULINA
Entity Type:Individual
Prefix:
First Name:ADRIANA
Middle Name:PAULINA
Last Name:LOPEZ-MOYA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ADRIANA
Other - Middle Name:PAULINA
Other - Last Name:MOYA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:445 N SAN JOAQUIN ST
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95202-2026
Mailing Address - Country:US
Mailing Address - Phone:209-444-8910
Mailing Address - Fax:
Practice Address - Street 1:445 N SAN JOAQUIN ST
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95202-2026
Practice Address - Country:US
Practice Address - Phone:209-444-8910
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-26
Last Update Date:2015-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor