Provider Demographics
NPI:1750876777
Name:LOPEZ-SANCHEZ, KIMBERLY SHEREE (LCSW)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:SHEREE
Last Name:LOPEZ-SANCHEZ
Suffix:
Gender:F
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:PO BOX 381
Mailing Address - Street 2:
Mailing Address - City:MADERA
Mailing Address - State:CA
Mailing Address - Zip Code:93639-0381
Mailing Address - Country:US
Mailing Address - Phone:559-416-5909
Mailing Address - Fax:
Practice Address - Street 1:16645 ROAD 26 BLDG B
Practice Address - Street 2:
Practice Address - City:MADERA
Practice Address - State:CA
Practice Address - Zip Code:93638-0830
Practice Address - Country:US
Practice Address - Phone:559-416-5909
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-22
Last Update Date:2023-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCSW1092851041C0700X
CA1092851041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical