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NPI Code Detail

MEDICARE: BRENDA SOFIA LOPEZ

MEDICARE: BRENDA SOFIA LOPEZ
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1373H00000XDay Training/Habilitation Specialist
2390200000XStudent in an Organized Health Care Education/Training ProgramCA

General Provider Information

NPI Number : 1023875895
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRENDA SOFIA LOPEZ
Provider Business Mailing Address
First Line : 368 FELL ST
Second Line :
City : SAN FRANCISCO
State : CA
Zip : 94102-5144
Country : US
Telephone Number : 415-861-0828
Fax Number :
Provider Business Practice Location Address
First Line : 2481 HARRISON ST
Second Line :
City : SAN FRANCISCO
State : CA
Zip : 94110-2710
Country : US
Telephone Number : 415-861-0828
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/28/2024
Last Update Date : 05/28/2026

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Directions to “ BRENDA SOFIA LOPEZ ” Practice Location

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