Provider Demographics
NPI:1063540029
Name:LOPEZ, SUZANNE VALDERRAMA (PARAPROFESSIONAL)
Entity type:Individual
Prefix:MRS
First Name:SUZANNE
Middle Name:VALDERRAMA
Last Name:LOPEZ
Suffix:
Gender:F
Credentials:PARAPROFESSIONAL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 EL TORO DR
Mailing Address - Street 2:
Mailing Address - City:HOLLISTER
Mailing Address - State:CA
Mailing Address - Zip Code:95023-4230
Mailing Address - Country:US
Mailing Address - Phone:831-634-1276
Mailing Address - Fax:408-842-0757
Practice Address - Street 1:6980 CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:GILROY
Practice Address - State:CA
Practice Address - Zip Code:95020-6635
Practice Address - Country:US
Practice Address - Phone:408-846-4708
Practice Address - Fax:408-842-0757
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health