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General NPI Number Information
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NPI Number | 1821903923
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Entity Type | Individual
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Provider Name | GEOVANY LOPEZ
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Gender | Male
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Dates
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Enumeration Date | 08/14/2026
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Last Update Date | 08/14/2026
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Provider Practice Location Address
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Address Line | 3675 PECOS-MCLEOD INTERCONNECT #100
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City | LAS VEGAS
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State | NV
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Zip | 89121
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Country | US
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Telephone | 702-986-9695
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Fax |
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Provider Business Mailing Address
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Address Line | 8920 PERFECT DIAMOND CT
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City | LAS VEGAS
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State | NV
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Zip | 89129-7082
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Country | US
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Telephone | 323-354-1009
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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 | 103TA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Psychologist
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License Number | 08350-I
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License Number State | NV
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