Individual
BRENDA LIZETH LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ASW
Contact information
Practice address
3665 KEARNY VILLA RD STE 101, SAN DIEGO, CA 92123-1954
(858) 966-5832
Mailing address
3665 KEARNY VILLA RD STE 101, SAN DIEGO, CA 92123-1954
(858) 966-5832
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
119630
CA
106S00000X
Behavior Technician
RBT-19-103001
CA
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
10/23/2019
Last updated
01/09/2024
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