Healthcare Provider Details

I. General information

NPI: 1326551409
Provider Name (Legal Business Name): EMMA REYES LOPEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/10/2017
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15305 RAYEN ST
NORTH HILLS CA
91343-5117
US

IV. Provider business mailing address

15305 RAYEN ST
NORTH HILLS CA
91343-5117
US

V. Phone/Fax

Practice location:
  • Phone: 818-892-3423
  • Fax: 818-893-4509
Mailing address:
  • Phone: 818-892-3423
  • Fax: 818-893-4509

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number131362
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: