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NPI Code Detail

MEDICARE: ELLEN ANN LOPEZ LAADC CA

MEDICARE: ELLEN ANN LOPEZ LAADC CA
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
1101YA0400XAddiction (Substance Use Disorder) CounselorLCI04330815CA

General Provider Information

NPI Number : 1548780216
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELLEN ANN LOPEZ LAADC CA
Provider Business Mailing Address
First Line : 4281 KATELLA AVE STE 211
Second Line :
City : LOS ALAMITOS
State : CA
Zip : 90720-6500
Country : US
Telephone Number : 562-594-8444
Fax Number : 562-248-0477
Provider Business Practice Location Address
First Line : 4281 KATELLA AVE STE 211
Second Line :
City : LOS ALAMITOS
State : CA
Zip : 90720-6500
Country : US
Telephone Number : 562-594-8444
Fax Number : 562-248-0477
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/23/2017
Last Update Date : 02/13/2024

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Directions to “ ELLEN ANN LOPEZ LAADC CA” Practice Location

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