MEDICARE: GUADALUPE 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	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1518582329
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GUADALUPE LOPEZ

Provider Business Mailing Address
First Line	:	21515 HAWTHORNE BLVD
Second Line	:	GL-100
City	:	TORRANCE
State	:	CA
Zip	:	90503-6501
Country	:	US
Telephone Number	:	424-571-2618
Fax Number	:

Provider Business Practice Location Address
First Line	:	21515 HAWTHORNE BLVD
Second Line	:
City	:	TORRANCE
State	:	CA
Zip	:	90503-6501
Country	:	US
Telephone Number	:	424-571-2618
Fax Number	:

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

Provider Enumeration Date	:	06/08/2020
Last Update Date	:	05/18/2026

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Directions to “ GUADALUPE LOPEZ ” Practice Location

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