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General NPI Number Information
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NPI Number | 1760277321
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Entity Type | Individual
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Provider Name | NOAH ANTHONY LOPEZ
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Gender | Male
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Dates
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Enumeration Date | 04/14/2025
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Last Update Date | 04/14/2025
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Provider Practice Location Address
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Address Line | 15437 ANACAPA RD STE 30
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City | VICTORVILLE
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State | CA
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Zip | 92392-2458
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Country | US
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Telephone | 760-983-9269
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Fax |
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Provider Business Mailing Address
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Address Line | 18491 MECCA ST
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City | HESPERIA
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State | CA
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Zip | 92345-7419
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Country | US
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Telephone | 909-579-9909
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 145276
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License Number State | CA
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