Individual
SANDRA LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BS
Contact information
Practice address
14814 GAGELY DR, LA MIRADA, CA 90638-2116
(626) 533-5157
Mailing address
14814 GAGELY DR, LA MIRADA, CA 90638-2116
(626) 533-5157
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
7670
CA
Other
Enumeration date
06/17/2014
Last updated
06/17/2014
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