Provider Demographics
NPI:1255096608
Name:LOPEZ, NURIA (LMFT)
Entity type:Individual
Prefix:
First Name:NURIA
Middle Name:
Last Name:LOPEZ
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2651 E CHAPMAN AVE STE 215D
Mailing Address - Street 2:
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92831-3722
Mailing Address - Country:US
Mailing Address - Phone:562-569-9312
Mailing Address - Fax:
Practice Address - Street 1:2651 E CHAPMAN AVE STE 215D
Practice Address - Street 2:
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92831-3722
Practice Address - Country:US
Practice Address - Phone:562-569-9312
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-01
Last Update Date:2024-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA49678106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty