Provider Demographics
NPI:1588385264
Name:LOPEZ, ARIANNA (DACM, LAC)
Entity type:Individual
Prefix:MS
First Name:ARIANNA
Middle Name:
Last Name:LOPEZ
Suffix:
Gender:F
Credentials:DACM, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1286 UNIVERSITY AVE # 211
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92103-3312
Mailing Address - Country:US
Mailing Address - Phone:212-960-3020
Mailing Address - Fax:
Practice Address - Street 1:1517 CYPRESS AVE
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-4516
Practice Address - Country:US
Practice Address - Phone:212-960-3020
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-09
Last Update Date:2022-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA19453171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist