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General NPI Number Information
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NPI Number | 1821714452
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Entity Type | Individual
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Provider Name | KANDI MARIE LOPEZ ASW
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Gender | Female
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Dates
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Enumeration Date | 10/14/2022
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Last Update Date | 01/28/2026
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Provider Practice Location Address
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Address Line | 3109 N MILLBROOK AVE
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City | FRESNO
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State | CA
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Zip | 93703-1425
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Country | US
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Telephone | 559-600-9180
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Fax |
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Provider Business Mailing Address
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Address Line | 6569 N RIVERSIDE DR STE 102
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City | FRESNO
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State | CA
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Zip | 93722-9319
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Country | US
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Telephone |
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 122476
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 122476
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License Number State | CA
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