Provider Demographics
NPI:1477437242
Name:LOPEZ, VICTORIA (PPS)
Entity type:Individual
Prefix:MRS
First Name:VICTORIA
Middle Name:
Last Name:LOPEZ
Suffix:
Gender:F
Credentials:PPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1996 CABRILLO AVE
Mailing Address - Street 2:
Mailing Address - City:TULARE
Mailing Address - State:CA
Mailing Address - Zip Code:93274-8571
Mailing Address - Country:US
Mailing Address - Phone:559-302-7836
Mailing Address - Fax:
Practice Address - Street 1:640 E PLEASANT AVE
Practice Address - Street 2:
Practice Address - City:TULARE
Practice Address - State:CA
Practice Address - Zip Code:93274-2124
Practice Address - Country:US
Practice Address - Phone:559-685-7330
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-04
Last Update Date:2025-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA210056847103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool