Individual
AMANDA LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5870 ARLINGTON AVE, RIVERSIDE, CA 92504-2037
(951) 683-6596
Mailing address
5870 ARLINGTON AVE, RIVERSIDE, CA 92504-2037
(951) 683-6596
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
R1196420315
CA
Other
Enumeration date
01/10/2020
Last updated
01/10/2020
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