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General NPI Number Information
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NPI Number | 1326246406
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Entity Type | Individual
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Provider Name | MRS. GLORIA LOPEZ
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Gender | Female
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Dates
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Enumeration Date | 07/10/2007
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Last Update Date | 04/15/2025
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Provider Practice Location Address
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Address Line | 1523 LONGBRANCH AVE
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City | GROVER BEACH
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State | CA
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Zip | 93433-2508
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Country | US
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Telephone | 805-473-7004
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Fax | 805-473-7188
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Provider Business Mailing Address
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Address Line | 201 W CHAPEL ST
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City | SANTA MARIA
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State | CA
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Zip | 93458-4303
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Country | US
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Telephone | 805-922-2243
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | CI38070423
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | ASW120341
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License Number State | CA
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