Jamie L Lopez

Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Thermal, CA

NPI 1053924746 · NPPES record last updated Aug 24, 2020

Key facts

NPI
1053924746
Entity type
Individual (NPI type 1)
Primary specialty
Addiction (Substance Use Disorder) Counselor 101YA0400X
License
R93511214 (CA)
Practice address
83385 Rosa Ave
Thermal, CA 92274-9506
Phone
(760) 398-2008
NPI assigned
Aug 24, 2020
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
R93511214CAMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Riverside County Latino Commission on Alcohol and Drug Services, Inc Past
since Aug 30, 2020
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X R93511214 CA Yes

Addresses

Primary practice location

83385 Rosa Ave
Thermal, CA 92274-9506

Mailing address

1612 1St St
Coachella, CA 92236-1407
Phone (760) 398-9000

Other providers in Thermal, CA

All providers in Thermal, CA · Addiction (Substance Use Disorder) Counselor in California

Sources for this page

Verify at the official NPI Registry.