Provider Demographics
NPI:1780007245
Name:LOPEZ, NATALIA M (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:NATALIA
Middle Name:M
Last Name:LOPEZ
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7170 N FINANCIAL DR STE 101
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720-2935
Mailing Address - Country:US
Mailing Address - Phone:718-909-6267
Mailing Address - Fax:
Practice Address - Street 1:7170 N FINANCIAL DR STE 101
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-2935
Practice Address - Country:US
Practice Address - Phone:718-909-6267
Practice Address - Fax:559-314-6166
Is Sole Proprietor?:No
Enumeration Date:2014-02-03
Last Update Date:2024-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20633235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist