Healthcare Provider Details

I. General information

NPI: 1518763283
Provider Name (Legal Business Name): MARGARET ELAINE LOPEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MEL LOPEZ

II. Dates (important events)

Enumeration Date: 02/21/2025
Last Update Date: 02/21/2025
Certification Date: 02/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7498 N REMINGTON AVE STE 102
FRESNO CA
93711-5508
US

IV. Provider business mailing address

2273 ROBERTS AVE
CLOVIS CA
93611-6260
US

V. Phone/Fax

Practice location:
  • Phone: 888-585-7373
  • Fax:
Mailing address:
  • Phone: 559-593-5201
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225C00000X
TaxonomyRehabilitation Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: