Individual
ADRIENNE LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3467 W SHAW AVE, SUITE #102, FRESNO, CA 93711-3223
(559) 274-0299
Mailing address
5743 W MESA AVE, FRESNO, CA 93722-3179
(559) 274-0299
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100332
STAFF NUMBER
CA
Enumeration date
02/26/2007
Last updated
07/08/2007
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