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General NPI Number Information
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NPI Number | 1386158715
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Entity Type | Individual
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Provider Name | MAYRA LOPEZ LPCC20612
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Gender | Female
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Dates
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Enumeration Date | 11/21/2017
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Last Update Date | 09/29/2025
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Provider Practice Location Address
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Address Line | 380 COALINGA PLZ
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City | COALINGA
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State | CA
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Zip | 93210-1704
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Country | US
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Telephone | 855-343-1057
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Fax | 844-563-6078
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Provider Business Mailing Address
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Address Line | 380 COALINGA PLZ
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City | COALINGA
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State | CA
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Zip | 93210-1704
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Country | US
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Telephone | 855-343-1057
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Fax | 844-587-6405
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LPCC20612
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 5898
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License Number State | CA
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