Individual
AVERY KIAMA LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3192 GLEN CANYON RD, SCOTTS VALLEY, CA 95066-4916
(831) 438-2020
Mailing address
536 OCEAN VIEW AVE, SANTA CRUZ, CA 95062-3339
(831) 998-3153
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
95431995
CA
Other
Enumeration date
02/06/2026
Last updated
02/06/2026
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