| NPI | 1639569296 |
|---|---|
| Former Name | JESSICA ANDREA LOPEZ |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA LMFT110650) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA IMF85100) |
| Enumeration Date | 2015-02-03 |
| Last Update Date | 2024-07-16 |