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General NPI Number Information
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NPI Number | 1366715831
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Entity Type | Individual
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Provider Name | ANALIS LOPEZ GONZALES LMSW
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Gender | Female
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Dates
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Enumeration Date | 02/14/2012
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Last Update Date | 06/12/2018
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Provider Practice Location Address
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Address Line | 1468 MADISON AVE FL 4
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City | NEW YORK
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State | NY
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Zip | 10029
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Country | US
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Telephone | 646-899-9648
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Fax | 212-996-9685
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Provider Business Mailing Address
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Address Line | 1751 CLOVERFIELD BLVD
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City | SANTA MONICA
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State | CA
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Zip | 90404-4007
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Country | US
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Telephone | 310-450-0650
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Fax | 310-883-1221
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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 | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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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 |
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License Number State |
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