Individual
JORGE ANDRES LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
160 S 7TH AVE, LA PUENTE, CA 91746-3211
(626) 961-8971
Mailing address
160 S 7TH AVE, LA PUENTE, CA 91746-3211
(626) 961-8971
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
172V00000X
Community Health Worker
—
—
373H00000X
Day Training/Habilitation Specialist
Primary
—
CA
Other
Enumeration date
09/12/2022
Last updated
05/07/2025
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