Simon Lopez, ACSW
Counselor, Mental Health in Barstow, CA. Individual provider (NPI-1).
NPI number1760103501
StatusActive
Last updated in NPPESJan 30, 2023
Details
- NPI
- 1760103501
- Entity type
- Individual (NPI-1)
- Name
- Mr. Simon Lopez
- Credential
- ACSW
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Sep 9, 2022
- Certification date
- Jan 30, 2023
- Last updated
- Jan 30, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YM0800X | Counselor, Mental Health | 109737 | CA | Yes |
Practice location
309 E Mountain View StBarstow, CA 92311-2897
Phone 254-368-0874
Mailing address
309 E Mountain View StBarstow, CA 92311-2897
Phone 254-368-0874
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