MEDICARE: JOANNA LOPEZ

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker

General Provider Information

NPI Number	:	1114383890
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOANNA LOPEZ

Provider Business Mailing Address
First Line	:	50 BEALE ST FL 12
Second Line	:	P.O. BPX 194247
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94105-1813
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	50 BEALE ST FL 12
Second Line	:	P.O. BPX 194247
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94105-1813
Country	:	US
Telephone Number	:	415-615-5677
Fax Number	:	415-615-6477

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/11/2016
Last Update Date	:	01/11/2016

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Directions to “ JOANNA LOPEZ ” Practice Location

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