Individual
ALEX LOPEZ JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1160 S GRAND AVE, GLENDORA, CA 91740-5000
(626) 335-5980
Mailing address
1160 S GRAND AVE, GLENDORA, CA 91740-5000
(626) 335-5980
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
225400000X
Rehabilitation Practitioner
—
—
Other
Enumeration date
03/02/2009
Last updated
03/20/2009
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