Individual
VERENICE IVETTE LOPEZ-MEZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3230 KERNER BLVD, SAN RAFAEL, CA 94901-4840
(415) 473-5063
Mailing address
3230 KERNER BLVD, SAN RAFAEL, CA 94901-4840
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
175T00000X
Peer Specialist
Primary
MPSS-HSMBLG
CA
225400000X
Rehabilitation Practitioner
—
—
Other
Enumeration date
04/20/2022
Last updated
05/30/2023
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