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General NPI Number Information
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NPI Number | 1568432326
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Entity Type | Individual
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Provider Name | BEN LAWRENCE LOPEZ LCSW
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Gender | Male
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Dates
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Enumeration Date | 01/25/2006
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Last Update Date | 08/01/2022
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Provider Practice Location Address
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Address Line | 3765 GRASS VALLEY HWY #252 STE 9
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City | AUBURN
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State | CA
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Zip | 95602-2036
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Country | US
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Telephone | 530-887-8220
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Fax | 530-885-2205
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Provider Business Mailing Address
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Address Line | 3765 GRASS VALLEY HWY #252 STE 9
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City | AUBURN
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State | CA
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Zip | 95602-2036
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Country | US
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Telephone | 530-887-8220
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Fax | 530-885-2205
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | LCS006151
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 006151
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License Number State | CA
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