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NPI Code Detail

MEDICARE: MRS. MICHELLE LORRAINE LOPEZ

MEDICARE:  MRS. MICHELLE LORRAINE 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
1101YA0400XAddiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number : 1871674671
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MICHELLE LORRAINE LOPEZ
Provider Business Mailing Address
First Line : 1609 WOOD LK
Second Line :
City : SANTA ANA
State : CA
Zip : 92705-6990
Country : US
Telephone Number : 714-834-7863
Fax Number : 714-834-8235
Provider Business Practice Location Address
First Line : 1609 WOOD LK
Second Line :
City : SANTA ANA
State : CA
Zip : 92705-6990
Country : US
Telephone Number : 714-834-7863
Fax Number : 714-834-8235
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/18/2006
Last Update Date : 07/08/2007

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Directions to “ MRS. MICHELLE LORRAINE LOPEZ ” Practice Location

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