BRENDA IRENE LOPEZ BLAKE

ANAHEIM, CA
NPI1679213037
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy363A00000X Physician Assistant
(Licence: CA  62055)
Additional Taxonomies390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date2022-03-31
Last Update Date2024-09-06
Business Address
BRENDA IRENE LOPEZ BLAKE
1182 N EUCLID ST
ANAHEIM, CA 92801-1900
Phone number: 714-441-0411
Mailing Address
BRENDA IRENE LOPEZ BLAKE
1182 N EUCLID ST
ANAHEIM, CA 92801-1900
Phone number: 714-441-0411