Individual
ENETTE MARIE LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ASCW
Contact information
Practice address
496 S BARTON AVE, FRESNO, CA 93702-2985
(559) 860-4422
Mailing address
3433 W SHAW AVE STE 108, FRESNO, CA 93711-3229
(559) 558-4051
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
118115
CA
1041C0700X
Clinical Social Worker
LMSW-18251
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100328
STAFF NUMBER
CA
05
—
104100000X
—
CA
Enumeration date
02/21/2007
Last updated
07/02/2024
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