Basic Information
| Provider Information | |||||||||
| NPI: | 1700539327 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LOPES | ||||||||
| FirstName: | MARCI | ||||||||
| MiddleName: | RHEA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 251 LLEWELLYN AVE | ||||||||
| Address2: | |||||||||
| City: | CAMPBELL | ||||||||
| State: | CA | ||||||||
| PostalCode: | 950081940 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4083793790 | ||||||||
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| Practice Location | |||||||||
| Address1: | 9343 TECH CENTER DR FL 2 | ||||||||
| Address2: | |||||||||
| City: | SACRAMENTO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 958262563 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9163886400 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/02/2022 | ||||||||
| LastUpdateDate: | 02/02/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/02/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101Y00000X | 223743 | HI | Y | Behavioral Health & Social Service Providers | Counselor |
No ID Information.