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NPI Code Detail

MEDICARE: SOPHIA LOPEZ

MEDICARE: SOPHIA 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
1103K00000XBehavior Analyst1-24-78627CA

General Provider Information

NPI Number : 1144039751
Entity Type Code : Individual
Provider Name (Legal Business Name) : SOPHIA LOPEZ
Provider Business Mailing Address
First Line : 15206 DICKENS ST APT 10
Second Line :
City : SHERMAN OAKS
State : CA
Zip : 91403-3359
Country : US
Telephone Number : 818-605-9207
Fax Number :
Provider Business Practice Location Address
First Line : 2707 W EMPIRE AVE
Second Line :
City : BURBANK
State : CA
Zip : 91504-3212
Country : US
Telephone Number : 818-639-3568
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/07/2025
Last Update Date : 01/07/2025

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Directions to “ SOPHIA LOPEZ ” Practice Location

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