JERRY WAYNE LOPEZ

RIALTO, CA
NPI1023155694
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YM0800X Counselor, Mental Health
(Licence: CA  22964)
Enumeration Date2007-01-31
Last Update Date2007-07-08
Business Address
Mr. JERRY WAYNE LOPEZ PT
850 E FOOTHILL BLVD
RIALTO, CA 92376-5230
Phone number: 909-421-9370
Mailing Address
Mr. JERRY WAYNE LOPEZ PT
8189 PALMETTO AVE APT 212
FONTANA, CA 92335-3692
Phone number: 909-561-6473