Most Relevant Information
Provider Data
| NPI Number: | 1003548447 |
| Provider Name: | GISSELLE LOPEZ |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 06/24/2022 |
| Last Updated: | 06/24/2022 |
Provider Practice Location
39899 BALENTINE DR STE 128
NEWARK
CA
945605361
Practice Location Phone/Fax
| Phone: | 6509316300 |
| Fax: |
Provider Mailing Location
39899 BALENTINE DR STE 128
NEWARK
CA
945605361
Provider Mailing Phone/Fax
| Phone: | 6509316300 |
| Fax: |