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NPI Code Detail

MEDICARE: KASSANDRA LOPEZ

MEDICARE: KASSANDRA 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
1106S00000XBehavior Technician
2106S00000XBehavior TechnicianCA

General Provider Information

NPI Number : 1386208155
Entity Type Code : Individual
Provider Name (Legal Business Name) : KASSANDRA LOPEZ
Provider Business Mailing Address
First Line : 11150 W OLYMPIC BLVD STE 1160
Second Line :
City : LOS ANGELES
State : CA
Zip : 90064-1826
Country : US
Telephone Number : 510-397-2851
Fax Number :
Provider Business Practice Location Address
First Line : 11150 W OLYMPIC BLVD STE 1160
Second Line :
City : LOS ANGELES
State : CA
Zip : 90064-1826
Country : US
Telephone Number : 510-397-2851
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/26/2019
Last Update Date : 03/13/2024

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Directions to “ KASSANDRA LOPEZ ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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