Healthcare Provider Details

I. General information

NPI: 1609377548
Provider Name (Legal Business Name): JULIA MARIE LOPEZ MS, BCABA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/26/2018
Last Update Date: 11/19/2024
Certification Date: 11/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

208 OAK ST
BAKERSFIELD CA
93304-2433
US

IV. Provider business mailing address

208 OAK ST
BAKERSFIELD CA
93304-2433
US

V. Phone/Fax

Practice location:
  • Phone: 323-426-6402
  • Fax:
Mailing address:
  • Phone: 323-426-6402
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number0-18-8668
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: