Individual
EDNA M OSORIO LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
926 W PHILADELPHIA ST UNIT 84, ONTARIO, CA 91762-6240
(909) 238-5267
Mailing address
926 W PHILADELPHIA ST UNIT 84, ONTARIO, CA 91762-6240
(909) 238-5267
Taxonomy
Speciality
Code
Description
License number
State
103TR0400X
Rehabilitation Psychologist
Primary
OTA3935
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NA
NA
CA
Enumeration date
11/07/2019
Last updated
11/07/2019
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