Michael Gerald Lopez

Individual provider Active NPI Behavior Technician · Fillmore, CA

NPI 1629834239 · NPPES record last updated Feb 22, 2024

Key facts

NPI
1629834239
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
Practice address
163 4TH St
Fillmore, CA 93015-1417
Phone
(805) 206-5882
NPI assigned
Feb 22, 2024
Sex
Male
Sole proprietor
Yes

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X Yes

Addresses

Primary practice location

163 4TH St
Fillmore, CA 93015-1417

Mailing address

163 4TH St
Fillmore, CA 93015-1417
Phone (805) 206-5882

Other providers in Fillmore, CA

All providers in Fillmore, CA · Behavior Technician in California

Sources for this page

Verify at the official NPI Registry.