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NPI Code Detail

MEDICARE: DENISE ISABEL LOLA M.S.

MEDICARE: DENISE ISABEL LOLA M.S.
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
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1386206886
Entity Type Code : Individual
Provider Name (Legal Business Name) : DENISE ISABEL LOLA M.S.
Provider Business Mailing Address
First Line : 560 E HOSPITALITY LN STE 400
Second Line :
City : SAN BERNARDINO
State : CA
Zip : 92408-3545
Country : US
Telephone Number : 909-891-1599
Fax Number :
Provider Business Practice Location Address
First Line : 560 E HOSPITALITY LN STE 400
Second Line :
City : SAN BERNARDINO
State : CA
Zip : 92408-3545
Country : US
Telephone Number : 909-891-1599
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/03/2019
Last Update Date : 07/09/2025

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Directions to “ DENISE ISABEL LOLA M.S.” Practice Location

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