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NPI Code Detail

MEDICARE: MS. PRISCILLA LOPEZ BA

MEDICARE:  MS. PRISCILLA  LOPEZ  BA
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

General Provider Information

NPI Number : 1851932438
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. PRISCILLA LOPEZ BA
Provider Business Mailing Address
First Line : 2230 WILMA AVE
Second Line :
City : COMMERCE
State : CA
Zip : 90040-3933
Country : US
Telephone Number : 323-359-1364
Fax Number :
Provider Business Practice Location Address
First Line : 1000 CORPORATE CENTER DR STE 120
Second Line :
City : MONTEREY PARK
State : CA
Zip : 91754-7610
Country : US
Telephone Number : 855-345-2273
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/04/2019
Last Update Date : 10/04/2019

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Directions to “ MS. PRISCILLA LOPEZ BA” Practice Location

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