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Individual
LETICIA LOPEZ
Active
Individual
LETICIA LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
B.S.
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
95-2633765
MEDI-CAL
CA
Enumeration date
02/17/2015
Last updated
09/22/2016
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