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General NPI Number Information
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NPI Number | 1568379246
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Entity Type | Individual
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Provider Name | CHRISTANGEL LOPEZ GONZALEZ
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Gender | Male
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Dates
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Enumeration Date | 08/26/2026
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Last Update Date | 08/26/2026
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Provider Practice Location Address
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Address Line | 4880 MARKET ST
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City | VENTURA
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State | CA
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Zip | 93003-7783
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Country | US
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Telephone | 310-895-8396
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Fax |
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Provider Business Mailing Address
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Address Line | 1310 W 177TH ST APT 206
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City | GARDENA
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State | CA
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Zip | 90248-3435
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Country | US
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Telephone | 310-895-8396
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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 | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number | Y6833620
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License Number State | CA
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