Provider Demographics
NPI:1063544013
Name:LOPEZ, VERONICA R
Entity type:Individual
Prefix:
First Name:VERONICA
Middle Name:R
Last Name:LOPEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:444 GRAVES AVE APT 19
Mailing Address - Street 2:
Mailing Address - City:EL CAJON
Mailing Address - State:CA
Mailing Address - Zip Code:92020-3617
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:395 BALLANTYNE ST
Practice Address - Street 2:#305
Practice Address - City:EL CAJON
Practice Address - State:CA
Practice Address - Zip Code:92020-3922
Practice Address - Country:US
Practice Address - Phone:619-588-3653
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor