Provider Demographics
NPI:1275346207
Name:LOPEZ, ALENA ANAHI
Entity type:Individual
Prefix:MS
First Name:ALENA
Middle Name:ANAHI
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 1:75 W BURLWOOD LN
Mailing Address - Street 2:
Mailing Address - City:LEMOORE
Mailing Address - State:CA
Mailing Address - Zip Code:93245-2311
Mailing Address - Country:US
Mailing Address - Phone:559-772-2484
Mailing Address - Fax:
Practice Address - Street 1:75 W BURLWOOD LN
Practice Address - Street 2:
Practice Address - City:LEMOORE
Practice Address - State:CA
Practice Address - Zip Code:93245-2311
Practice Address - Country:US
Practice Address - Phone:559-772-2484
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-31
Last Update Date:2025-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician