Individual
DR. JOSE DE JESUS LOPEZ ANDRADE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
510 S VERMONT AVE, LOS ANGELES, CA 90020-1912
(310) 253-6332
Mailing address
510 S VERMONT AVE, LOS ANGELES, CA 90020-1912
(310) 253-6332
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
225C00000X
Rehabilitation Counselor
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01536011
MEDI-CAL
CA
Enumeration date
11/19/2015
Last updated
04/15/2025
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