Basic Information
| Provider Information | |||||||||
| NPI: | 1770877789 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LOPEZ | ||||||||
| FirstName: | MARCELA | ||||||||
| MiddleName: | |||||||||
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| Credential: | ACSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3628 STOCKDALE HWY | ||||||||
| Address2: | |||||||||
| City: | BAKERSFIELD | ||||||||
| State: | CA | ||||||||
| PostalCode: | 933092153 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6613221021 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 3628 STOCKDALE HWY | ||||||||
| Address2: | |||||||||
| City: | BAKERSFIELD | ||||||||
| State: | CA | ||||||||
| PostalCode: | 93309 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6613221021 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/07/2011 | ||||||||
| LastUpdateDate: | 03/10/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/10/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 104100000X | ASW78753 | CA | N | Behavioral Health & Social Service Providers | Social Worker | 104100000X | N | Behavioral Health & Social Service Providers | Social Worker | 1041C0700X | ASW78753 | CA | N | Behavioral Health & Social Service Providers | Social Worker | Clinical | 1041C0700X | LCSW100056 | CA | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.