Individual
SANDRA LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1150 FREMONT BLVD, SEASIDE, CA 93955-5715
(831) 899-8100
(831) 899-8105
Mailing address
1150 FREMONT BLVD, SEASIDE, CA 93955-5715
(831) 899-8100
(831) 899-8105
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
07/29/2015
Last updated
07/29/2015
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