Organization
BIG LIFE CHANGE THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GABRIELLE LOPEZ (AMFT)
(646) 228-8602
Entity
Organization
Contact information
Practice address
822 D ST, SAN RAFAEL, CA 94901-2814
(510) 831-3502
Mailing address
822 D ST, SAN RAFAEL, CA 94901-2814
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
03/27/2026
Last updated
03/27/2026
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