Individual
MS. CONNIE LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
625 FAIR OAKS AVE FL 1, SOUTH PASADENA, CA 91030-2630
(626) 861-4475
Mailing address
15308 REGALADO ST, HACIENDA HEIGHTS, CA 91745-4433
(626) 627-0311
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
175T00000X
Peer Specialist
Primary
MPSS-AJPVHI
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
171M00000X
CASE MANAGER
CA
Enumeration date
12/28/2011
Last updated
05/17/2024
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