# DAVID LOPEZ MARRIAGE AND FAMILY THERAPIST INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1215768734
- **Authorized official:** MR. DAVID LOPEZ LMFT (PRESIDENT AND CEO)
- **Authorized official phone:** (209) 626-8118

## Contact information

- **Practice address:** 3600 SISK RD \# 5A-16, MODESTO, CA 95356-0535
- **Practice address phone:** (209) 626-8118
- **Practice address fax:** (209) 502-7035
- **Mailing address:** PO BOX 578534, MODESTO, CA 95357-8534
- **Mailing address phone:** (209) 626-8118

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 106H00000X | Marriage & Family Therapist | — | NULL | Yes |
| 106H00000X | Marriage & Family Therapist | — | — | Yes |

## Other

- **Enumeration date:** 08/08/2024
- **Last updated:** 08/08/2024