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1740827195
JACK LOPEZ
WEST COVINA, CA
NPI
1740827195
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
103K00000X Behavior Analyst
(Licence: CA 1-23-63964)
Enumeration Date
2019-12-04
Last Update Date
2024-11-12
Business Address
JACK LOPEZ BCBA
1050 WEST LAKES DR #225 PMB #3097
WEST COVINA, CA 91790
Phone number: 323-943-4400
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Mailing Address
JACK LOPEZ BCBA
1050 LAKES DR STE 225 PMB #3097
WEST COVINA, CA 91790-2910
Phone number: 323-943-4400
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