Healthcare Provider Details

I. General information

NPI: 1831844687
Provider Name (Legal Business Name): WENDY LOPEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/18/2022
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14535 SHERMAN CIR
VAN NUYS CA
91405-3087
US

IV. Provider business mailing address

14716 CHATSWORTH ST
MISSION HILLS CA
91345-2141
US

V. Phone/Fax

Practice location:
  • Phone: 818-901-4930
  • Fax:
Mailing address:
  • Phone: 818-271-1615
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number16774
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: