Individual
AURELIO LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1100 W SHAW AVE STE 130, FRESNO, CA 93711-3708
(559) 681-1947
Mailing address
1100 W SHAW AVE STE 130, FRESNO, CA 93711-3708
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1295972446
—
CA
Enumeration date
01/05/2016
Last updated
01/05/2016
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