Provider Demographics
NPI:1245402437
Name:LOPEZ, ERIKA LISBETH (MA)
Entity type:Individual
Prefix:MS
First Name:ERIKA
Middle Name:LISBETH
Last Name:LOPEZ
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 W REDONDO BEACH BLVD # 1031
Mailing Address - Street 2:
Mailing Address - City:GARDENA
Mailing Address - State:CA
Mailing Address - Zip Code:90247-4203
Mailing Address - Country:US
Mailing Address - Phone:310-400-0141
Mailing Address - Fax:
Practice Address - Street 1:701 W REDONDO BEACH BLVD # 1031
Practice Address - Street 2:
Practice Address - City:GARDENA
Practice Address - State:CA
Practice Address - Zip Code:90247-4203
Practice Address - Country:US
Practice Address - Phone:310-400-0141
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-27
Last Update Date:2024-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95344106H00000X
CA127331106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist