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NPI Code Detail

MEDICARE: MR. FERMIN LOZA

MEDICARE: MR. FERMIN LOZA
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
1101YA0400XAddiction (Substance Use Disorder) Counselor040931CA

General Provider Information

NPI Number : 1659421022
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. FERMIN LOZA
Provider Business Mailing Address
First Line : 3378 SHASTA DR
Second Line :
City : SAN MATEO
State : CA
Zip : 94403-3766
Country : US
Telephone Number : 415-725-1996
Fax Number :
Provider Business Practice Location Address
First Line : 890 HAYES ST
Second Line :
City : SAN FRANCISCO
State : CA
Zip : 94117-2615
Country : US
Telephone Number : 415-701-5174
Fax Number : 415-621-1033
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/10/2007
Last Update Date : 03/31/2017

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Directions to “ MR. FERMIN LOZA ” Practice Location

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