Individual
AMBER-GRACE LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RADT
Contact information
Practice address
901 W VICTORIA ST STE F&G, COMPTON, CA 90220-5807
(310) 669-9510
(310) 669-9501
Mailing address
3837 MCNAB AVE, LONG BEACH, CA 90808-2218
(562) 357-5704
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
R1509280623
CA
225400000X
Rehabilitation Practitioner
Primary
—
—
Other
Enumeration date
07/27/2023
Last updated
09/05/2024
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