Individual
SANDRA MARIE LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1212 N CALIFORNIA ST, STOCKTON, CA 95202-1552
(209) 468-8686
Mailing address
44 N SAN JOAQUIN ST STE 550, STOCKTON, CA 95202-2925
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
172V00000X
Community Health Worker
—
—
175T00000X
Peer Specialist
Primary
MPSSSOFXPM
CA
Other
Enumeration date
09/08/2015
Last updated
02/09/2024
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