Provider Demographics
NPI:1932714508
Name:LOPEZ, SABRINA NATALIA
Entity Type:Individual
Prefix:MS
First Name:SABRINA
Middle Name:NATALIA
Last Name:LOPEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:555 NORTH PERRIS BLVD
Mailing Address - Street 2:
Mailing Address - City:PERRIS
Mailing Address - State:CA
Mailing Address - Zip Code:92571
Mailing Address - Country:US
Mailing Address - Phone:951-436-5300
Mailing Address - Fax:
Practice Address - Street 1:555 NORTH PERRIS BLVD
Practice Address - Street 2:
Practice Address - City:PERRIS
Practice Address - State:CA
Practice Address - Zip Code:92571
Practice Address - Country:US
Practice Address - Phone:951-436-5300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-10
Last Update Date:2023-11-29
Deactivation Date:2023-10-04
Deactivation Code:
Reactivation Date:2023-10-11
Provider Licenses
StateLicense IDTaxonomies
171M00000X, 106S00000X
CA142893106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician