MEDICARE: ITZEL 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	283Q00000X	Psychiatric Hospital

General Provider Information

NPI Number	:	1316399660
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ITZEL LOPEZ

Provider Business Mailing Address
First Line	:	1869 LOMBARD ST
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94123-2909
Country	:	US
Telephone Number	:	415-595-5626
Fax Number	:

Provider Business Practice Location Address
First Line	:	1869 LOMBARD ST
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94123-2909
Country	:	US
Telephone Number	:	415-595-5626
Fax Number	:

Authorized Official
Title or Position	:	SOCIAL WORKER
Name	:	MS. ITZEL LOPEZ
Credential	:	LMFT
Telephone Number	:	415-595-5626

Provider Enumeration Date	:	07/11/2016
Last Update Date	:	04/16/2025

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