MEDICARE: STEPHANIE MARIE LOPEZ TORRES PH.D.

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	103TC0700X	Clinical Psychologist	8181	PR

General Provider Information

NPI Number	:	1356283907
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHANIE MARIE LOPEZ TORRES PH.D.

Provider Business Mailing Address
First Line	:	BUZON 1606
Second Line	:	BO. JUAN SANCHEZ
City	:	BAYAMON
State	:	PR
Zip	:	00959-0000
Country	:	US
Telephone Number	:	787-362-8494
Fax Number	:

Provider Business Practice Location Address
First Line	:	BUZON 1606
Second Line	:	BO. JUAN SANCHEZ
City	:	BAYAMON
State	:	PR
Zip	:	00959-0000
Country	:	US
Telephone Number	:	787-362-8494
Fax Number	:

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

Provider Enumeration Date	:	04/06/2026
Last Update Date	:	04/06/2026

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