Individual
JENNIFER MARIE LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2945 MCMILLAN AVE STE 240, SAN LUIS OBISPO, CA 93401-6771
(805) 439-4890
Mailing address
2945 MCMILLAN AVE STE 240, SAN LUIS OBISPO, CA 93401-6771
(805) 439-4890
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
205365
CA
Other
Enumeration date
09/08/2020
Last updated
09/08/2020
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