Individual
IRIS JOHANA LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
205 E TRAVIS BLVD APT B, FAIRFIELD, CA 94533-3957
(707) 740-9100
Mailing address
205 E TRAVIS BLVD APT B, FAIRFIELD, CA 94533-3957
(707) 740-9100
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
CA
Other
Enumeration date
04/08/2021
Last updated
04/08/2021
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