MEDICARE: WENDY M LOPATA LCSW

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	1041C0700X	Clinical Social Worker	LCS 26771	CA

General Provider Information

NPI Number	:	1689952848
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WENDY M LOPATA LCSW

Provider Business Mailing Address
First Line	:	107 S FAIR OAKS AVE STE 327
Second Line	:
City	:	PASADENA
State	:	CA
Zip	:	91105-2086
Country	:	US
Telephone Number	:	323-600-3920
Fax Number	:

Provider Business Practice Location Address
First Line	:	107 S FAIR OAKS AVE STE 327
Second Line	:
City	:	PASADENA
State	:	CA
Zip	:	91105-2086
Country	:	US
Telephone Number	:	323-600-3920
Fax Number	:

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

Provider Enumeration Date	:	07/21/2011
Last Update Date	:	06/01/2026

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