Healthcare Provider Details

I. General information

NPI: 1073489167
Provider Name (Legal Business Name): KAREN ROBLES LOPEZ
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/15/2025
Last Update Date: 10/15/2025
Certification Date: 10/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15720 VENTURA BLVD STE 420
ENCINO CA
91436-4711
US

IV. Provider business mailing address

15720 VENTURA BLVD STE 420
ENCINO CA
91436-4711
US

V. Phone/Fax

Practice location:
  • Phone: 818-927-0478
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: