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NPI Code Detail

MEDICARE: ALICIA IXCHEL LOPEZ-YGLESIAS

MEDICARE: ALICIA IXCHEL LOPEZ-YGLESIAS
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
1106H00000XMarriage & Family TherapistAMFT128886CA
2390200000XStudent in an Organized Health Care Education/Training Program
3106H00000XMarriage & Family TherapistCA

General Provider Information

NPI Number : 1235751249
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALICIA IXCHEL LOPEZ-YGLESIAS
Provider Business Mailing Address
First Line : PO BOX 4
Second Line :
City : MIDWAY CITY
State : CA
Zip : 92655-0004
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 300 S HARBOR BLVD STE 910
Second Line :
City : ANAHEIM
State : CA
Zip : 92805-3721
Country : US
Telephone Number : 562-821-1491
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/12/2020
Last Update Date : 03/28/2024

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Directions to “ ALICIA IXCHEL LOPEZ-YGLESIAS ” Practice Location

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