Most Relevant Information
Provider Data
| NPI Number: | 1003520131 |
| Provider Name: | IVIANA LOPEZ |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 01/12/2023 |
| Last Updated: | 01/12/2023 |
Provider Practice Location
3320 DATA DR STE 400
RANCHO CORDOVA
CA
956707341
Practice Location Phone/Fax
| Phone: | 9165645010 |
| Fax: |
Provider Mailing Location
3320 DATA DR STE 400
RANCHO CORDOVA
CA
956707341
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |