Healthcare Provider Details

I. General information

NPI: 1205601812
Provider Name (Legal Business Name): VERONICA LOPEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/24/2023
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

INSIGHT FAMILY COUNSELING AND WELLNESS SERVICES INC 12321 MAGNOLIA AVE, SUITE D
RIVERSIDE CA
92503
US

IV. Provider business mailing address

INSIGHT FAMILY COUNSELING AND WELLNESS SERVICES INC 12321 MAGNOLIA AVE, SUITE D
RIVERSIDE CA
92503
US

V. Phone/Fax

Practice location:
  • Phone: 714-681-0052
  • Fax: 213-201-3993
Mailing address:
  • Phone: 714-681-0052
  • Fax: 213-201-3993

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberASW134384
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: