Individual
GLADYS OLIVIA LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3433 W SHAW AVE # 107, FRESNO, CA 93711-3229
(559) 476-2115
Mailing address
3433 W SHAW AVE STE 102, FRESNO, CA 93711-3229
(559) 558-4051
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
172V00000X
Community Health Worker
—
—
373H00000X
Day Training/Habilitation Specialist
Primary
—
—
Other
Enumeration date
12/03/2021
Last updated
06/05/2025
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