Provider Demographics
NPI:1194918268
Name:LOPEZ, ROSALINDA
Entity type:Individual
Prefix:MRS
First Name:ROSALINDA
Middle Name:
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 1:975 FLYNN RD
Mailing Address - Street 2:
Mailing Address - City:CAMARILLO
Mailing Address - State:CA
Mailing Address - Zip Code:93012-8704
Mailing Address - Country:US
Mailing Address - Phone:805-388-7740
Mailing Address - Fax:805-482-0987
Practice Address - Street 1:975 FLYNN RD
Practice Address - Street 2:
Practice Address - City:CAMARILLO
Practice Address - State:CA
Practice Address - Zip Code:93012-8704
Practice Address - Country:US
Practice Address - Phone:805-388-7740
Practice Address - Fax:805-482-0987
Is Sole Proprietor?:No
Enumeration Date:2007-08-22
Last Update Date:2007-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health