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General NPI Number Information
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NPI Number | 1023519303
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Entity Type | Individual
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Provider Name | ARMANDO LOPEZ
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Gender | Male
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Dates
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Enumeration Date | 02/22/2018
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Last Update Date | 09/10/2025
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Provider Practice Location Address
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Address Line | 1581 CUMMINS DR STE B
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City | MODESTO
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State | CA
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Zip | 95358-6402
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Country | US
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Telephone | 209-492-5113
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Fax | 209-574-1541
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Provider Business Mailing Address
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Address Line | 3041 SARIYA WAY
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City | CERES
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State | CA
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Zip | 95307-9202
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Country | US
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Telephone | 209-416-8651
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171400000X
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Taxonomy Name | Health & Wellness Coach
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License Number | 3D26ECD19F
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1-19-36295
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License Number State | CA
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