Healthcare Provider Details

I. General information

NPI: 1528956547
Provider Name (Legal Business Name): DEBORAH LOPEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/26/2025
Last Update Date: 01/21/2026
Certification Date: 01/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

46883 MONROE ST
INDIO CA
92201-6768
US

IV. Provider business mailing address

46883 MONROE ST
INDIO CA
92201-6768
US

V. Phone/Fax

Practice location:
  • Phone: 760-398-9090
  • Fax:
Mailing address:
  • Phone: 760-398-9090
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberAPCC21275
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberAMFT159966
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: