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Individual
MRS. MAYRA LOPEZ
Active
Individual
MRS. MAYRA LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ACSW
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
LCSW96461
CA
1041C0700X
Clinical Social Worker
Primary
LCSW96461
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1104371905
—
CA
Enumeration date
08/22/2016
Last updated
12/17/2021
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