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Individual

NICOLE LOPEZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ATC

Contact information

Practice address
309 CRAWFORD HALL, IRVINE, CA 92697-0001
(949) 824-2876
Mailing address
16372 MARUFFA CIR, HUNTINGTON BEACH, CA 92649-2134

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary

Other

Enumeration date
06/25/2019
Last updated
06/25/2019
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