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General NPI Number Information
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NPI Number | 1306132980
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Entity Type | Individual
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Provider Name | DANIEL RAY LOPEZ COUNSELOR
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Gender | Male
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Dates
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Enumeration Date | 06/22/2011
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Last Update Date | 03/06/2025
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Provider Practice Location Address
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Address Line | 1612 1ST ST
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City | COACHELLA
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State | CA
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Zip | 92236-1407
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Country | US
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Telephone | 760-398-9000
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Fax |
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Provider Business Mailing Address
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Address Line | 83844 HOPI AVE
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City | INDIO
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State | CA
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Zip | 92203-2638
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Country | US
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Telephone | 760-347-9442
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Fax | 760-342-8022
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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 | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number | 11180
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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